Provider Demographics
NPI:1992079552
Name:TAYLOR-MADE HEALTH AND WELLNESS
Entity type:Organization
Organization Name:TAYLOR-MADE HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN-PIERRE
Authorized Official - Middle Name:S
Authorized Official - Last Name:SILVERA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:352-989-5555
Mailing Address - Street 1:185 N HIGHWAY 27
Mailing Address - Street 2:SUITE A
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-2400
Mailing Address - Country:US
Mailing Address - Phone:352-989-5555
Mailing Address - Fax:352-432-2121
Practice Address - Street 1:185 N HIGHWAY 27
Practice Address - Street 2:SUITE A
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2400
Practice Address - Country:US
Practice Address - Phone:352-989-5555
Practice Address - Fax:352-432-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9498111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty