Provider Demographics
NPI:1548556236
Name:SMITH, TAJUANNA TAYLOR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TAJUANNA
Middle Name:TAYLOR
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:TAJUANNA
Other - Middle Name:TYSHA
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1200 LINTON BLVD
Mailing Address - Street 2:T-0642
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-1115
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 LINTON BLVD
Practice Address - Street 2:T-0642
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-1115
Practice Address - Country:US
Practice Address - Phone:561-266-0754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36034183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist