Provider Demographics
NPI:1356825970
Name:CONSIGLIO-TAYLOR, KRISTIN MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MARIE
Last Name:CONSIGLIO-TAYLOR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3191 E SEMORAN BLVD
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-5943
Mailing Address - Country:US
Mailing Address - Phone:407-788-6500
Mailing Address - Fax:407-869-9440
Practice Address - Street 1:3191 E SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-5943
Practice Address - Country:US
Practice Address - Phone:407-788-6500
Practice Address - Fax:407-869-9440
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
363A00000X
FL9111544363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant