Individual
KONSTANTIN TARASOVSKIY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 GANDY BLVD N UNIT 516, ST PETERSBURG, FL 33702-2124
(813) 770-3118
Mailing address
1400 GANDY BLVD N UNIT 516, ST PETERSBURG, FL 33702-2124
(813) 770-3118
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
T621-519-68-378-0
FL
Other
Enumeration date
06/11/2014
Last updated
06/11/2014
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