Provider Demographics
NPI:1477163772
Name:PLAMONDON, TAYLOR TREVOR (RN)
Entity Type:Individual
Prefix:MR
First Name:TAYLOR
Middle Name:TREVOR
Last Name:PLAMONDON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6322 GUNN HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-4105
Mailing Address - Country:US
Mailing Address - Phone:813-864-3998
Mailing Address - Fax:
Practice Address - Street 1:6322 GUNN HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-4105
Practice Address - Country:US
Practice Address - Phone:813-864-3998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9497164163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant