Provider Demographics
NPI:1578228433
Name:BROWN, TAYLOR JANE
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:JANE
Last Name:BROWN
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 1:4704B W MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33616-1042
Mailing Address - Country:US
Mailing Address - Phone:813-597-9614
Mailing Address - Fax:
Practice Address - Street 1:4704B W MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33616-1042
Practice Address - Country:US
Practice Address - Phone:813-597-9614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator