Provider Demographics
NPI:1598251712
Name:TAYLOR, BRANDON ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:ROBERT
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5608 SE 113TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:BELLEVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:34420-4069
Mailing Address - Country:US
Mailing Address - Phone:352-245-8955
Mailing Address - Fax:
Practice Address - Street 1:5608 SE 113TH ST STE A
Practice Address - Street 2:
Practice Address - City:BELLEVIEW
Practice Address - State:FL
Practice Address - Zip Code:34420-4069
Practice Address - Country:US
Practice Address - Phone:352-245-8955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12516111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor