Provider Demographics
NPI:1619995461
Name:TAGGART, DOREY L (ARNP)
Entity Type:Individual
Prefix:
First Name:DOREY
Middle Name:L
Last Name:TAGGART
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 864074
Mailing Address - Street 2:HALIFAX HEALTHCARE SYSTEMS, INC.
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-4074
Mailing Address - Country:US
Mailing Address - Phone:386-226-4590
Mailing Address - Fax:386-226-3371
Practice Address - Street 1:303 NO. CLYDE MORRIS BLVD., ROC
Practice Address - Street 2:HALIFAX HEALTH CENTER FOR ONCOLOGY
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-2709
Practice Address - Country:US
Practice Address - Phone:386-254-4211
Practice Address - Fax:386-254-4038
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704263736363LF0000X
FLARNP9303710363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily