Provider Demographics
NPI:1750561437
Name:HOSSLER, TAMARA S
Entity type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:S
Last Name:HOSSLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18350 VICENZA WAY
Mailing Address - Street 2:
Mailing Address - City:MIROMAR LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8923
Mailing Address - Country:US
Mailing Address - Phone:239-494-2891
Mailing Address - Fax:
Practice Address - Street 1:18350 VICENZA WAY
Practice Address - Street 2:
Practice Address - City:MIROMAR LAKES
Practice Address - State:FL
Practice Address - Zip Code:33913-8923
Practice Address - Country:US
Practice Address - Phone:239-494-2891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist