Provider Demographics
NPI:1295892768
Name:FILES-HALL, TARA MICHELE (PHD)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:MICHELE
Last Name:FILES-HALL
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 1:6977 PROFESSIONAL PARKWAY EAST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-8411
Mailing Address - Country:US
Mailing Address - Phone:941-224-8131
Mailing Address - Fax:941-718-4896
Practice Address - Street 1:6977 PROFESSIONAL PARKWAY EAST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-8411
Practice Address - Country:US
Practice Address - Phone:941-224-8131
Practice Address - Fax:941-718-4896
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6987103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL282940OtherWELLCARE PROVIDER NUMBER
FL74436OtherBCBS PROVIDER NUMBER
FL74436AMedicare ID - Type UnspecifiedPROVIDER NUMBER