Individual
MRS. TARA MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-1771
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-1771
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN9283439
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020350600
—
FL
01
—
PENDING
MEDICARE HF
FL
Enumeration date
02/06/2016
Last updated
08/14/2024
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