Provider Demographics
NPI:1265834584
Name:ENGERT, TAYLOR (M S)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:ENGERT
Suffix:
Gender:F
Credentials:M S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3470 E COAST AVE
Mailing Address - Street 2:H903
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3986
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3470 E COAST AVE
Practice Address - Street 2:H903
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3986
Practice Address - Country:US
Practice Address - Phone:727-365-3585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLE526814887550101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health