Provider Demographics
NPI:1285042549
Name:TEMNICK, TAYLOR MAE (EDD, LAT, ATC, CES,)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MAE
Last Name:TEMNICK
Suffix:
Gender:F
Credentials:EDD, LAT, ATC, CES,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 S HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-1852
Mailing Address - Country:US
Mailing Address - Phone:727-587-0377
Mailing Address - Fax:727-548-1360
Practice Address - Street 1:8900 PARK BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33777-4119
Practice Address - Country:US
Practice Address - Phone:727-545-4545
Practice Address - Fax:727-548-1360
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-30
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYAT10682255A2300X
FLAL54562255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer