Provider Demographics
NPI:1891253746
Name:ADAMS, TAYLER RAYANNA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:TAYLER
Middle Name:RAYANNA
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MARINER HEALTH WAY STE 213
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-3251
Mailing Address - Country:US
Mailing Address - Phone:904-217-4259
Mailing Address - Fax:904-217-4251
Practice Address - Street 1:4320 A1A S STE 7
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-7436
Practice Address - Country:US
Practice Address - Phone:904-679-3449
Practice Address - Fax:904-679-3436
Is Sole Proprietor?:No
Enumeration Date:2019-03-11
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT34469225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist