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NPI Code Detail

MEDICARE: LATASHA TANNER RPH

MEDICARE:   LATASHA  TANNER  RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS53586FL

General Provider Information

NPI Number : 1316542087
Entity Type Code : Individual
Provider Name (Legal Business Name) : LATASHA TANNER RPH
Provider Business Mailing Address
First Line : 884 LICARIA DR
Second Line :
City : OCOEE
State : FL
Zip : 34761-3948
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6354 N ORANGE BLOSSOM TRL
Second Line :
City : ORLANDO
State : FL
Zip : 32810-4202
Country : US
Telephone Number : 407-290-0366
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2020
Last Update Date : 12/01/2020

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Directions to “ LATASHA TANNER RPH” Practice Location

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