Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | OS14697 | FL |
Y | 111NI0900X | Internist | OS14697 | FL |
NPI | 1003235359 |
---|---|
Provider Name | Zachary Taylor |
First Address | Gainesville, FL 32610-3003 |
Second Address | Gainesville, FL 32610-3003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2014 |
Last Update Date | 07/06/2017 |