Individual
DR. BRENT ROBERT TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1541 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4124
(866) 400-3376
Mailing address
3180 N POINT PKWY, STE 420, ALPHARETTA, GA 30005-4568
(407) 875-2080
(407) 650-3455
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
32031
SC
207N00000X
Dermatology Physician
73661
GA
207N00000X
Dermatology Physician
ME120226
FL
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
73661
GA
207NS0135X
Procedural Dermatology Physician
A124812
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012735800
—
FL
Enumeration date
06/30/2009
Last updated
06/07/2021
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