Provider Demographics
NPI:1467968297
Name:MARTOS, TARAH ROGOWSKI (PHD)
Entity Type:Individual
Prefix:DR
First Name:TARAH
Middle Name:ROGOWSKI
Last Name:MARTOS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 MADRUGA AVE STE 225
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3051
Mailing Address - Country:US
Mailing Address - Phone:786-953-4620
Mailing Address - Fax:
Practice Address - Street 1:1550 MADRUGA AVE STE 225
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3051
Practice Address - Country:US
Practice Address - Phone:786-953-4620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-15
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program