Provider Demographics
NPI:1235899501
Name:FLITCRAFT, TAYLOR SMITH (OTR/L)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:SMITH
Last Name:FLITCRAFT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:3210 JENKS AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4224
Mailing Address - Country:US
Mailing Address - Phone:850-763-0603
Mailing Address - Fax:850-769-5914
Practice Address - Street 1:13405 PANAMA CITY BEACH PKWY STE A
Practice Address - Street 2:
Practice Address - City:PANAMA CITY BEACH
Practice Address - State:FL
Practice Address - Zip Code:32407-2885
Practice Address - Country:US
Practice Address - Phone:850-236-7497
Practice Address - Fax:850-236-7499
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22630225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist