Provider Demographics
NPI:1538348479
Name:TAYLOR, RONALD WILLIAM JR
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:WILLIAM
Last Name:TAYLOR
Suffix:JR
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:R.
Other - Middle Name:WILLIAM
Other - Last Name:TAYLOR
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:415 LAKEPOINTE DR
Mailing Address - Street 2:#110
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5863
Mailing Address - Country:US
Mailing Address - Phone:407-401-9408
Mailing Address - Fax:
Practice Address - Street 1:415 LAKEPOINTE DR
Practice Address - Street 2:#110
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5863
Practice Address - Country:US
Practice Address - Phone:407-401-9408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-28
Last Update Date:2007-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9605204D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine