Individual
MS. TARA BRINSON MCDANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCMA
Contact information
Practice address
5791 UNIVERSITY CLUB BLVD N UNIT 208, JACKSONVILLE, FL 32277-9406
(904) 405-5181
Mailing address
5791 UNIVERSITY CLUB BLVD N UNIT 208, JACKSONVILLE, FL 32277-9406
(904) 405-5181
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
236472
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
769789
—
FL
Enumeration date
02/12/2021
Last updated
03/15/2021
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