Taylen Peaden D.O. PLLC
Family Medicine in Lake City, FL. Organization (NPI-2).
NPI number1710693858
StatusActive
Last updated in NPPESJan 23, 2023
Details
- NPI
- 1710693858
- Entity type
- Organization (NPI-2)
- Legal business name
- Taylen Peaden D.O. PLLC
- Organization subpart
- No
- Enumeration date
- Jan 23, 2023
- Certification date
- Jan 23, 2023
- Last updated
- Jan 23, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
1111 Sw Main BlvdLake City, FL 32025-5767
Phone 386-365-4922
Mailing address
1111 Sw Main BlvdLake City, FL 32025-5767
Authorized official
Taylen Clay Peaden
Owner
3863654922
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