Provider Demographics
NPI:1619959996
Name:TAYLOR, ARLENE L (DO)
Entity Type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:L
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3385 BURNS RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4328
Mailing Address - Country:US
Mailing Address - Phone:561-249-0149
Mailing Address - Fax:561-249-0151
Practice Address - Street 1:3385 BURNS RD
Practice Address - Street 2:SUITE 207
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4328
Practice Address - Country:US
Practice Address - Phone:561-249-0149
Practice Address - Fax:561-249-0151
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9363207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274885100Medicaid
FL274885100Medicaid