Taylor, Brent Robert

Taylor, Brent Robert is an sole proprietor health care provider with primary practice located at 1541 Riverside Ave , Jacksonville FL 32204-4124. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Procedural Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Taylor, Brent Robert can be contacted via phone (866) 400-3376.

Contact Information

Primary practice address
1541 Riverside Ave Jacksonville FL 32204-4124
Phone: (866) 400-3376
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 32031 South Carolina
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 73661 Georgia
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X A124812 California
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 73661 Georgia
Allopathic & Osteopathic Physicians / Dermatology 207N00000X ME120226 Florida

Profile Details

NPI number 1316175128
LBN Legal business name Taylor, Brent Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 30th, 2009
Last updated Jun 7th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316175128 NPPES
Florida MEDICAID 012735800

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