Provider Demographics
NPI:1578729935
Name:TARR, RICHARD DORAN (RN)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:DORAN
Last Name:TARR
Suffix:
Gender:M
Credentials:RN
Other - Prefix:MR
Other - First Name:RICHARD
Other - Middle Name:DORAN
Other - Last Name:TARR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:3834 TWILIGHT DR
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-5329
Mailing Address - Country:US
Mailing Address - Phone:813-689-8956
Mailing Address - Fax:
Practice Address - Street 1:13100 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612
Practice Address - Country:US
Practice Address - Phone:813-972-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP820312163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult