Healthcare Provider Details

I. General information

NPI: 1275646838
Provider Name (Legal Business Name): MICHAEL H. TARLOWE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 09/01/2021
Certification Date: 09/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 W HILLSBORO BLVD STE 302
DEERFIELD BEACH FL
33442-1100
US

IV. Provider business mailing address

22155 TRILLIUM WAY
BOCA RATON FL
33433-4843
US

V. Phone/Fax

Practice location:
  • Phone: 954-333-8838
  • Fax:
Mailing address:
  • Phone: 908-305-3389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME149426
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number235531
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number235531
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberME149426
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: