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Individual

TIAJUANA TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RRT

Contact information

Practice address
4410 WILLIAMSBURG AVE, JACKSONVILLE, FL 32208-1745
(904) 765-2988
Mailing address
6648 KANE CREEK DR, JACKSONVILLE, FL 32244-3498
(904) 887-2255

Taxonomy

Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
RT13595
FL
251S00000X
Community/Behavioral Health Agency
Primary
385H00000X
Respite Care

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016673400
FL
Enumeration date
11/17/2016
Last updated
11/17/2016
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