Provider Demographics
NPI:1033827506
Name:SWARTZENTRUBER, TAYLOR (PT, DPT, LAT, ATC)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:SWARTZENTRUBER
Suffix:
Gender:F
Credentials:PT, DPT, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 GARDENIA ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-8733
Mailing Address - Country:US
Mailing Address - Phone:812-617-2112
Mailing Address - Fax:
Practice Address - Street 1:1451 2ND ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-4905
Practice Address - Country:US
Practice Address - Phone:941-203-8705
Practice Address - Fax:941-203-8786
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-14
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36003487A2255A2300X
FLPT417492251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer