Provider Demographics
NPI:1124535471
Name:RICHARDS, TAMARA (ARNP)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:DAWN
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:616 MINORCA AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-3757
Mailing Address - Country:US
Mailing Address - Phone:305-781-5125
Mailing Address - Fax:
Practice Address - Street 1:616 MINORCA AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-3757
Practice Address - Country:US
Practice Address - Phone:305-781-5125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9191617363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology