Provider Demographics
NPI:1700802808
Name:TAYLOR, ANNE MARIE (AUD, CCC A)
Entity Type:Individual
Prefix:DR
First Name:ANNE MARIE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:AUD, CCC A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203C N HIGHWAY 79
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32413-2225
Mailing Address - Country:US
Mailing Address - Phone:850-588-5460
Mailing Address - Fax:850-588-5369
Practice Address - Street 1:203C N HIGHWAY 79
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32413-2225
Practice Address - Country:US
Practice Address - Phone:850-588-5460
Practice Address - Fax:850-588-5369
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1123231H00000X, 231HA2400X, 231HA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL600353200Medicaid
48 1294665OtherIRS
FL600353200Medicaid