| Doctor Name: | TAYLA MAE KAVANAUGH |
| NPI Number: | 1013292424 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | PA9106206 |
| Business Practice Address: | 601 Main St Dunedin, FL - 346985848 |
| Business Phone Number: | 7277331111 |
| Business Fax Number: | |
| Mailing Address: | 430 3rd Ave S, Apartment #137 ST PETERSBURG |
| State: | FL |
| Postal Code: | 337014144 |
| Phone Number: | 7163386949 |
| Fax Number: | |
| NPI Enumeration Date: | 10/17/2011 |
| NPI Last Update Date: | 02/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | PA9106206 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |