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Individual

DR. MINDY TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5535 S WILLIAMSON BLVD, SUITE 727, PORT ORANGE, FL 32128-8311
(386) 506-8701
(386) 265-0577
Mailing address
5535 S WILLIAMSON BLVD, SUITE 727, PORT ORANGE, FL 32128-8311
(386) 506-8701

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
PO3493
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006116800
FL
01
P01085890
RAILROAD PTAN
FL
Enumeration date
05/25/2011
Last updated
10/21/2015
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