Individual
TARA BAGEN SONNANSTINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
Mailing address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0925
(813) 978-9700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
R2811
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
ME134360
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2013
Last updated
03/23/2022
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