Provider Demographics
NPI:1952846685
Name:GUYHER, TARA TALISEA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:TALISEA
Last Name:GUYHER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:TALISEA GUYHER
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2576 BOOTS RD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33810-5158
Mailing Address - Country:US
Mailing Address - Phone:407-782-5077
Mailing Address - Fax:
Practice Address - Street 1:2576 BOOTS RD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33810-5158
Practice Address - Country:US
Practice Address - Phone:407-782-5077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS55653183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist