Provider Demographics
NPI:1750945689
Name:ISABEL TAYLOR LLC
Entity type:Organization
Organization Name:ISABEL TAYLOR LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:SHERELLE
Authorized Official - Last Name:TAYLOR-BOONE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:786-575-3801
Mailing Address - Street 1:2790 RIVER RUN CIR E
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4429
Mailing Address - Country:US
Mailing Address - Phone:786-575-3801
Mailing Address - Fax:954-342-9163
Practice Address - Street 1:1701 W FLAGLER ST STE 310
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-2099
Practice Address - Country:US
Practice Address - Phone:786-467-7006
Practice Address - Fax:786-999-0971
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ISABEL TAYLOR LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022925900Medicaid