Provider Demographics
NPI:1518340215
Name:WOLMER, TAYLOR W (DO)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:W
Last Name:WOLMER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6600 MADISON ST FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-1971
Mailing Address - Country:US
Mailing Address - Phone:813-815-7208
Mailing Address - Fax:727-266-4951
Practice Address - Street 1:6600 MADISON ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652
Practice Address - Country:US
Practice Address - Phone:727-815-7207
Practice Address - Fax:727-266-4951
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO4604207R00000X
FLOS15080207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100474900Medicaid