Provider Demographics
NPI:1235932732
Name:CARRO, TAYLOR CASSIDY I
Entity type:Individual
Prefix:MS
First Name:TAYLOR
Middle Name:CASSIDY
Last Name:CARRO
Suffix:I
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 ARCHDALE ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-0429
Mailing Address - Country:US
Mailing Address - Phone:631-766-5271
Mailing Address - Fax:
Practice Address - Street 1:126 ARCHDALE ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-0429
Practice Address - Country:US
Practice Address - Phone:631-766-5271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYE4D389202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology