MEDICARE: MS. TAMMY CERELIA FLUCAS CRT,RCP

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	2279C0205X	Critical Care Registered Respiratory Therapist	8068	GA

General Provider Information

NPI Number	:	1518352525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TAMMY CERELIA FLUCAS CRT,RCP

Provider Business Mailing Address
First Line	:	3871 MARGAUX DR
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30349-2056
Country	:	US
Telephone Number	:	919-559-9350
Fax Number	:

Provider Business Practice Location Address
First Line	:	3871 MARGAUX DR
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30349-2056
Country	:	US
Telephone Number	:	919-559-9350
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2015
Last Update Date	:	10/06/2015

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