Provider Demographics
NPI:1578034716
Name:DELGADO, TAYLOR G
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:G
Last Name:DELGADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 ATRIUM DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-3739
Mailing Address - Country:US
Mailing Address - Phone:786-447-1730
Mailing Address - Fax:
Practice Address - Street 1:1701 PARK CENTER DR STE 230
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6235
Practice Address - Country:US
Practice Address - Phone:321-445-1287
Practice Address - Fax:401-386-7448
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101907000Medicaid