Provider Demographics
NPI:1013336379
Name:TAMBURRINO, MARK ROBERT (LAC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:ROBERT
Last Name:TAMBURRINO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:26133 US HIGHWAY 19 N
Mailing Address - Street 2:SUITE 218
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763
Mailing Address - Country:US
Mailing Address - Phone:727-351-2882
Mailing Address - Fax:727-222-3540
Practice Address - Street 1:26133 US HIGHWAY 19 N
Practice Address - Street 2:SUITE 218
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763
Practice Address - Country:US
Practice Address - Phone:727-351-2882
Practice Address - Fax:727-222-3540
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2023-04-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLAP3424171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist