Individual
TAYLA MAE KAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
601 MAIN ST, DUNEDIN, FL 34698-5848
(727) 733-1111
Mailing address
430 3RD AVE S, APARTMENT #137, ST PETERSBURG, FL 33701-4144
(716) 338-6949
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9106206
FL
Other
Enumeration date
10/17/2011
Last updated
02/18/2016
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