Individual
TARA VANDENBOSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, CSCS, LAT
Contact information
Practice address
11300 NE 2ND AVE, MIAMI SHORES, FL 33161-6628
(308) 899-3572
Mailing address
5725 GARFIELD ST, HOLLYWOOD, FL 33021-5150
(860) 912-9745
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL4125
FL
Other
Enumeration date
09/07/2015
Last updated
09/07/2015
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