MEDICARE: TARA B PIRELA MEDICAL SUPPLY

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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1356131254
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TARA B PIRELA MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	1615 SW DUCLAIR AVE
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34953-4761
Country	:	US
Telephone Number	:	813-741-0490
Fax Number	:

Provider Business Practice Location Address
First Line	:	1615 SW DUCLAIR AVE
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34953-4761
Country	:	US
Telephone Number	:	813-741-0490
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TARA PIRELA
Credential	:
Telephone Number	:	813-741-0490

Provider Enumeration Date	:	05/12/2025
Last Update Date	:	05/12/2025

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