Individual
MS. LATARA VERNELL TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9608 REDWOOD BLVD, TAMPA, FL 33635-5932
(813) 298-9662
Mailing address
9608 REDWOOD BLVD, TAMPA, FL 33635-5932
(813) 298-9662
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
172V000000X
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
674745196
—
FL
05
—
674745198
—
FL
Enumeration date
12/01/2010
Last updated
12/01/2010
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