Provider Demographics
NPI:1275207425
Name:KARETAS, TASHA J (LPN, NBC-HWC)
Entity Type:Individual
Prefix:
First Name:TASHA
Middle Name:J
Last Name:KARETAS
Suffix:
Gender:F
Credentials:LPN, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13850 SW HIGHWAY 484
Mailing Address - Street 2:
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34432-5359
Mailing Address - Country:US
Mailing Address - Phone:321-616-5681
Mailing Address - Fax:
Practice Address - Street 1:13850 SW HIGHWAY 484
Practice Address - Street 2:
Practice Address - City:DUNNELLON
Practice Address - State:FL
Practice Address - Zip Code:34432-5359
Practice Address - Country:US
Practice Address - Phone:321-616-5681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLA-3255366