Provider Demographics
NPI:1265568604
Name:DENNIS, TARA N (DO)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:N
Last Name:DENNIS
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Gender:F
Credentials:DO
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Mailing Address - Street 1:8110 ROYAL PALM BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5795
Mailing Address - Country:US
Mailing Address - Phone:954-344-8288
Mailing Address - Fax:954-341-5165
Practice Address - Street 1:8110 ROYAL PALM BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5795
Practice Address - Country:US
Practice Address - Phone:954-344-8288
Practice Address - Fax:954-341-5165
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2010-05-19
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Provider Licenses
StateLicense IDTaxonomies
FLOS 10647207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology