Individual
TANIA GABRIEL NAZARETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
472 SW SANSOM LN, PORT SAINT LUCIE, FL 34953-2960
(772) 200-0345
(772) 200-0345
Mailing address
472 SW SANSOM LN, PORT SAINT LUCIE, FL 34953-2960
(772) 200-0345
(772) 200-0345
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
04/07/2026
Last updated
04/07/2026
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