Provider Demographics
NPI:1669129011
Name:TAYLOR DERMATOLOGY, PA
Entity type:Organization
Organization Name:TAYLOR DERMATOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-888-0121
Mailing Address - Street 1:600 E GOVERNMENT ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-6136
Mailing Address - Country:US
Mailing Address - Phone:850-888-0121
Mailing Address - Fax:850-202-7015
Practice Address - Street 1:600 E GOVERNMENT ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-6136
Practice Address - Country:US
Practice Address - Phone:850-888-0121
Practice Address - Fax:850-202-7015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-06
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty