Provider Demographics
NPI:1417923038
Name:TAYLOR, BRADLEY SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:SCOTT
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 NW 13TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2269
Mailing Address - Country:US
Mailing Address - Phone:561-955-6300
Mailing Address - Fax:833-625-1590
Practice Address - Street 1:801 MEADOWS RD STE 102
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2346
Practice Address - Country:US
Practice Address - Phone:561-955-6300
Practice Address - Fax:833-625-1590
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD057315L208G00000X
FLME173814208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7851406OtherAETNA
MD037221800Medicaid
PA73738OtherGEISINGER
PA210465OtherJOHNS HOPKINS
PA001897366Medicaid
PA413356OtherHIGHMARK BLUE SHIELD
PA058368FLTMedicare PIN
PAH62012Medicare UPIN
MD037221800Medicaid