Provider Demographics
NPI:1245420462
Name:TAYLOR, ALLEN (OD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 WEST CYPRESS CREEK ROAD
Mailing Address - Street 2:SUITE 1, SOUTH FLORIDA VISION
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309
Mailing Address - Country:US
Mailing Address - Phone:954-979-2191
Mailing Address - Fax:
Practice Address - Street 1:2900 WEST CYPRESS CREEK ROAD
Practice Address - Street 2:SUITE 1, SOUTH FLORIDA VISION
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309
Practice Address - Country:US
Practice Address - Phone:954-979-2191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 1787152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist