Individual
TARA PROCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2124 PARADISE POINT LN, APOPKA, FL 32703-9406
(321) 460-7028
Mailing address
2124 PARADISE POINT LANE, APOPKA, FL 32703
(321) 460-7028
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
234863
FL
Other
Enumeration date
06/23/2017
Last updated
07/21/2022
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