Provider Demographics
NPI:1508224999
Name:TAYLOR, LATONYA (APRN)
Entity Type:Individual
Prefix:
First Name:LATONYA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4651 SHERIDAN ST STE 270
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3422
Mailing Address - Country:US
Mailing Address - Phone:954-989-6000
Mailing Address - Fax:954-967-8962
Practice Address - Street 1:4651 SHERIDAN ST STE 270
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3422
Practice Address - Country:US
Practice Address - Phone:954-989-6000
Practice Address - Fax:954-967-8962
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9231542363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner