Individual
MS. TAMIRIA E. LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PN
Contact information
Practice address
224 SE 24TH ST, GAINESVILLE, FL 32641-7516
(352) 334-7900
(352) 955-3045
Mailing address
224 SE 24TH ST, GAINESVILLE, FL 32641-7516
(352) 334-7900
(352) 955-3045
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
PN5170720
FL
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN5170720
FLORIDA MEDICAL LICENSE
FL
Enumeration date
04/08/2010
Last updated
04/08/2010
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