| Taylor Made Medical Care, Llc | |
|
6500 W Newberry Rd Gainesville FL 32605-4309 | |
| (352) 333-4000 | |
| Not Available |
| Full Name | Taylor Made Medical Care, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 6500 W Newberry Rd, Gainesville, Florida |
| Authorized Official Name and Position | Dale Lee Taylor (OWNER / REGISTERED AGENT) |
| Authorized Official Contact | 5612024861 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Taylor Made Medical Care, Llc 1217 Nw 55th St Unit 15 Gainesville FL 32605-6464 Ph: (561) 202-4861 | Taylor Made Medical Care, Llc 6500 W Newberry Rd Gainesville FL 32605-4309 Ph: (352) 333-4000 |
| NPI Number | 1811495583 |
|---|---|
| Provider Enumeration Date | 01/29/2018 |
| Last Update Date | 01/29/2018 |
| Medicare PECOS PAC ID | 5799048708 |
|---|---|
| Medicare Enrollment ID | O20180404000987 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811495583 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME125557 (Florida) | Primary |
| Provider Name | Dale Lee Taylor |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053758805 PECOS PAC ID: 8426291808 Enrollment ID: I20160713002318 |
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