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Individual

GREGORY SCOTT TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
1874 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34952-5545
(772) 337-7676
(772) 337-9034
Mailing address
1874 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34952-5545
(772) 337-7676
(772) 337-9034

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW830
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AK132Z
FLORIDA MEDICARE MFAA-COASTAL PAIN LINKED TO 33576B
FL
01
Z154G
FLORIDA BCBS
FL
Enumeration date
10/26/2006
Last updated
05/10/2011
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