Individual
BEN TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7400 NW 70TH AVE, PARKLAND, FL 33067-3965
(754) 666-1696
Mailing address
7400 NW 70TH AVE, PARKLAND, FL 33067-3965
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000
CASH ONLY
—
Enumeration date
03/20/2020
Last updated
03/20/2020
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