Basic Information
| Provider Information | |||||||||
| NPI: | 1184254666 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TADROS | ||||||||
| FirstName: | TAMER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1950 N POINT BLVD APT 801 | ||||||||
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| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323084180 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8503455902 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2633 CENTENNIAL BLVD | ||||||||
| Address2: | |||||||||
| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323080605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8504315404 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2020 | ||||||||
| LastUpdateDate: | 01/23/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 9112868 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.