Provider Demographics
NPI:1104692896
Name:TAYLOR, TAJUANA
Entity type:Individual
Prefix:
First Name:TAJUANA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8210 MACEDONIA COMMONS BLVD
Mailing Address - Street 2:SUITE #3B PMB 1109
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056
Mailing Address - Country:US
Mailing Address - Phone:216-210-4916
Mailing Address - Fax:
Practice Address - Street 1:321 HARTSFIELD TER
Practice Address - Street 2:
Practice Address - City:MACEDONIA
Practice Address - State:OH
Practice Address - Zip Code:44056-1776
Practice Address - Country:US
Practice Address - Phone:216-210-4916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company