Provider Demographics
NPI:1952726671
Name:DOWNING, TARVARES JERMIANE
Entity Type:Individual
Prefix:
First Name:TARVARES
Middle Name:JERMIANE
Last Name:DOWNING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 TEMPLE CIR
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-6126
Mailing Address - Country:US
Mailing Address - Phone:863-353-2543
Mailing Address - Fax:863-353-2543
Practice Address - Street 1:1309 TEMPLE CIR
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-6126
Practice Address - Country:US
Practice Address - Phone:863-353-2543
Practice Address - Fax:863-353-2543
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No171M00000XOther Service ProvidersCase Manager/Care Coordinator