Individual
IMANI TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14501 AUDUBON TRCE, TAMPA, FL 33613-5410
(813) 586-0562
Mailing address
19046 BRUCE B DOWNS BLVD STE B6, TAMPA, FL 33647-2434
(813) 586-0562
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
12/27/2024
Last updated
12/27/2024
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