Provider Demographics
NPI:1265834584
Name:ROSAND, TAYLOR NICOLE (M S)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:NICOLE
Last Name:ROSAND
Suffix:
Gender:F
Credentials:M S
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:NICOLE
Other - Last Name:ENGERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9000 SHERIDAN ST STE 154
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8801
Mailing Address - Country:US
Mailing Address - Phone:954-281-2626
Mailing Address - Fax:
Practice Address - Street 1:9000 SHERIDAN ST STE 154
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-8801
Practice Address - Country:US
Practice Address - Phone:954-281-2626
Practice Address - Fax:954-281-5946
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15067101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health