Provider Demographics
NPI:1326332370
Name:TAYLOR, CHRISTIN LYN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIN
Middle Name:LYN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 10744
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33757-8744
Mailing Address - Country:US
Mailing Address - Phone:727-532-0002
Mailing Address - Fax:727-266-4943
Practice Address - Street 1:646 VIRGINIA ST FL 7
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-6612
Practice Address - Country:US
Practice Address - Phone:727-736-2730
Practice Address - Fax:727-635-2640
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME134498207Q00000X
ALMD.32429207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023536300Medicaid