Provider Demographics
NPI:1679531180
Name:TAYLOR, DENISE M (CRNA)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:M
Other - Last Name:FECHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1613 N. HARRISON PARKWAY
Mailing Address - Street 2:SUITE 200, MAILSTOP SH-9A
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2896
Mailing Address - Country:US
Mailing Address - Phone:954-838-2372
Mailing Address - Fax:954-851-1746
Practice Address - Street 1:1210 SOUTH OLD DIXIE HIGHWAY
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458
Practice Address - Country:US
Practice Address - Phone:561-649-3138
Practice Address - Fax:561-649-3029
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2513742367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG2876OtherBCBS
FLE5164ZMedicare ID - Type Unspecified