Provider Demographics
NPI:1063290724
Name:BLACK-ARAIZA, TAYLOR N (PT, DPT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:N
Last Name:BLACK-ARAIZA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 W PRESERVE WAY APT 307
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-6596
Mailing Address - Country:US
Mailing Address - Phone:469-964-4312
Mailing Address - Fax:
Practice Address - Street 1:17796 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-3923
Practice Address - Country:US
Practice Address - Phone:954-438-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist