Provider Demographics
NPI:1578618328
Name:TAYLOR, GAIL (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7398 KINDAL POINT
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-4339
Mailing Address - Country:US
Mailing Address - Phone:727-460-0810
Mailing Address - Fax:727-363-6002
Practice Address - Street 1:7398 KINDAL POINT
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33782-4339
Practice Address - Country:US
Practice Address - Phone:727-460-0810
Practice Address - Fax:727-363-6002
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 3546235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL887258900Medicaid