DR. BRENT ROBERT TAYLOR (NPI# 1316175128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316175128 |
| Entity Type | Individual |
| Full Name | DR. BRENT ROBERT TAYLOR |
| Credential | M.D. |
| Practice Address |
1541 Riverside Ave Jacksonville FL 32204-4124 |
| Mailing Address |
151 Southhall Ln Ste 300 Maitland FL 32751-7172 |
| Practice Telephone | 8664003376 |
| Mailing Telephone | 4078752080 |
| Mailing Fax Number | 4076503455 |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2016-07-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 73661 | GA | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | ME120226 | FL | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 32031 | SC | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
A124812 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 012735800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215076682 | Brent F Taylor | Physical Therapist | 3413 S 100 W, Bountiful, UT 84010-6639 | 2007-02-05 |
| 1770685000 | Brent Taylor | Surgery | 2490 S Woodworth Loop Ste 400, Palmer, AK 99645-7411 | 2006-09-05 |
| 1780032649 | Brent Taylor | Physician Assistant | 2347 E Gala St, Meridian, ID 83642-4881 | 2016-06-01 |
| 1346615507 | Brent Taylor | Counselor | 2860 E 19500 N, Moroni, UT 84646-0461 | 2015-12-14 |
| 1003034166 | Brent Taylor | Marriage & Family Therapist | 2423 Camino Del Rio S Ste 103, San Diego, CA 92108-3734 | 2007-04-23 |
| Street Address |
1541 RIVERSIDE AVE |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-4124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669464236 | Randolph Barret Mahoney | Physician Assistant | 1541 Riverside Ave, Jacksonville, FL 32204-4124 | 2005-08-18 |
| 1992851620 | North Florida Dermatology Associates, Pa | Specialist | 1541 Riverside Ave, Jacksonville, FL 32204-4124 | 2007-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
| 1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
| 1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
| 1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
| Find all providers in zip 32204 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902291784 | Brandon Tyler Beal | Dermatology | 6817 Southpoint Pkwy Ste 101, Jacksonville, FL 32216-6285 | 2015-03-30 |
| 1194079988 | Intracoastal Dermatology, Pllc | Dermatology | 4776 Hodges Blvd Ste 105, Jacksonville, FL 32224-7218 | 2012-11-01 |
| 1780861781 | Jacksonville Skin Cancer Center, P.a. | Dermatology | 4465 Baymeadows Rd Ste 5, Jacksonville, FL 32217-4727 | 2008-01-22 |
| 1720272644 | John Morello | Dermatology | 13111 Atlantic Blvd., Ste 4, Jacksonville, FL 32225 | 2007-09-04 |
| 1982740775 | Michael Edward Lutz | Dermatology | 4465 Baymeadows Rd, Suite 5, Jacksonville, FL 32217 | 2007-01-29 |
| 1386757540 | Joy R Boyne | Dermatology | 6869 Belfort Oaks Pl, Jacksonville, FL 32216-6242 | 2006-08-15 |
| 1124063391 | Robert Alan Baker | Dermatology | 11701-32 San Jose Blvd, Suite 216, Jacksonville, FL 32223 | 2006-06-19 |
| 1770521163 | James W Trimble | Dermatology | 6890 Belfort Oaks Pl, Jacksonville, FL 32216-6241 | 2006-06-04 |
| 1497709778 | Daniel J Abraham | Dermatology | 215b Station St, Jacksonville, NC 28546-6304 | 2006-05-20 |
| 1124076492 | Michael A. Gromet | Dermatology | 10036 Scott Mill Rd, Jacksonville, FL 32257-5885 | 2006-05-05 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
Please comment or provide details below to improve the information on DR. BRENT ROBERT TAYLOR.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.