Provider Demographics
NPI:1427158609
Name:TAYLOR, BRETT MARTIN (DC)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:MARTIN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1149 ROYAL PALM BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1669
Mailing Address - Country:US
Mailing Address - Phone:561-793-5050
Mailing Address - Fax:561-790-6766
Practice Address - Street 1:1149 ROYAL PALM BEACH BLVD
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1669
Practice Address - Country:US
Practice Address - Phone:561-793-5050
Practice Address - Fax:561-790-6766
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6543111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU59751Medicare UPIN
FL55295Medicare ID - Type Unspecified