Provider Demographics
NPI:1225495021
Name:TAYLOR, CARLY KLAES (DC)
Entity type:Individual
Prefix:DR
First Name:CARLY
Middle Name:KLAES
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CARLY
Other - Middle Name:DIANNE
Other - Last Name:KLAES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:605 CLAYTON ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4403
Mailing Address - Country:US
Mailing Address - Phone:812-216-0783
Mailing Address - Fax:
Practice Address - Street 1:3840 E SEMORAN BLVD STE 1054
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-6041
Practice Address - Country:US
Practice Address - Phone:407-880-1218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11775111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor