Individual
TAMMY NICOLE THAGGERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
555 W SR 434, LONGWOOD, FL 32750-5119
(407) 262-2220
(407) 834-5011
Mailing address
555 W SR 434, LONGWOOD, FL 32750-5119
(407) 262-2220
(407) 834-5011
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
82524
FL
207QA0505X
Adult Medicine Physician
Primary
ME82524
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019566300
—
FL
Enumeration date
08/10/2006
Last updated
12/17/2024
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