Provider Demographics
NPI:1891224994
Name:TAGES, BRITTNEY
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:TAGES
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 1:225 1ST AVE N UNIT 3410
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3765
Mailing Address - Country:US
Mailing Address - Phone:954-298-0652
Mailing Address - Fax:414-616-0202
Practice Address - Street 1:5290 S QUEBEC STREET
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80011
Practice Address - Country:US
Practice Address - Phone:954-546-2517
Practice Address - Fax:414-626-6202
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0061339208D00000X
SC87821208D00000X
ORDO218817208D00000X
CA20A18146208D00000X
NY299627208D00000X
NC2020-03413208D00000X
FLOS16651208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice