Provider Demographics
NPI:1629415781
Name:TAYLOR, ANDREA LOWERY (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:LOWERY
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E GOVERNMENT ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-6136
Mailing Address - Country:US
Mailing Address - Phone:850-888-0121
Mailing Address - Fax:850-202-7015
Practice Address - Street 1:600 E GOVERNMENT ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-6136
Practice Address - Country:US
Practice Address - Phone:850-888-0121
Practice Address - Fax:850-202-7015
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME128581207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology