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Individual

TATE STOREY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CAA

Contact information

Practice address
7700 W SUNRISE BLVD, PLANTATION, FL 33322-4113
(954) 838-2521
Mailing address
6159 DIMOND ST, JUPITER, FL 33458-6740
(561) 768-1172

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
AA341
FL

Other

Enumeration date
09/15/2016
Last updated
09/15/2016
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