Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS9605 | FL |
N | 207Q00000X | Family Doctor | OS9605 | FL |
NPI | 1538348479 |
---|---|
Provider Name | Dr. Ronald William Taylor JR. |
First Address | Altamonte Springs, FL 32701-5863 |
Second Address | Altamonte Springs, FL 32701-5863 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2007 |
Last Update Date | 28/10/2007 |