Provider Demographics
NPI:1972123628
Name:TAYLORMEDI FAMILY CARE CLINIC
Entity Type:Organization
Organization Name:TAYLORMEDI FAMILY CARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCKEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:239-645-5754
Mailing Address - Street 1:243 BETHANY HOME DR
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-7566
Mailing Address - Country:US
Mailing Address - Phone:239-645-5754
Mailing Address - Fax:
Practice Address - Street 1:243 BETHANY HOME DR
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-7566
Practice Address - Country:US
Practice Address - Phone:239-456-5754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care