Provider Demographics
NPI:1457770570
Name:TAYLOR, LAURA ANNE (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANNE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11016 LEGACY DR APT 101
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3635
Mailing Address - Country:US
Mailing Address - Phone:203-980-7128
Mailing Address - Fax:
Practice Address - Street 1:1411 N FLAGLER DR STE 4600
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3408
Practice Address - Country:US
Practice Address - Phone:561-942-7207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME162139207ND0101X
FL162139207ND0900X, 207ND0101X, 207N00000X
KY390200000X
PA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207N00000XAllopathic & Osteopathic PhysiciansDermatology