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Individual

MARY ANN TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1804 OPTIMIST DR, LAKELAND, FL 33801-6844
(863) 667-2212
(863) 667-2212
Mailing address
1804 OPTIMIST DR, LAKELAND, FL 33801-6844
(863) 667-2212
(863) 667-2212

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
679329196
FL
Enumeration date
09/15/2010
Last updated
09/15/2010
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