Provider Demographics
NPI:1295106755
Name:TAYLOR, RAYMOND MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:MICHAEL
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4750 THE GROVE DR STE 250
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-8427
Mailing Address - Country:US
Mailing Address - Phone:407-354-0717
Mailing Address - Fax:407-636-7878
Practice Address - Street 1:4750 THE GROVE DR STE 250
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-8427
Practice Address - Country:US
Practice Address - Phone:407-354-0717
Practice Address - Fax:407-636-7878
Is Sole Proprietor?:No
Enumeration Date:2015-10-09
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1528842083B0002X, 207Q00000X, 207Q00000X, 2083B0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH211OtherHF MA