Provider Demographics
NPI:1366893984
Name:UNGER, TAYLOR (AUD)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:
Last Name:UNGER
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 DUNLAWTON AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-4754
Mailing Address - Country:US
Mailing Address - Phone:386-756-8225
Mailing Address - Fax:386-767-0742
Practice Address - Street 1:1680 DUNLAWTON AVE
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-4754
Practice Address - Country:US
Practice Address - Phone:386-756-8225
Practice Address - Fax:386-767-0742
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2051231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAY2051OtherSTATE LICENSE