MEDICARE: DR. TARA BECKER M.D.

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	2084N0400X	Neurology Physician	23421	FL
2	390200000X	Student in an Organized Health Care Education/Training Program
3	2084N0400X	Neurology Physician	ME133503	FL

General Provider Information

NPI Number	:	1598119398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TARA BECKER M.D.

Provider Business Mailing Address
First Line	:	4631 N CONGRESS AVE STE 200
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3234
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4631 N CONGRESS AVE STE 200
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3234
Country	:	US
Telephone Number	:	561-845-0500
Fax Number	:

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

Provider Enumeration Date	:	04/18/2016
Last Update Date	:	06/07/2023

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