Healthcare Provider Details

I. General information

NPI: 1699931915
Provider Name (Legal Business Name): TARA NICOLE HROBOWSKI-BLACKMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 W BAY DR STE 103
LARGO FL
33770-2209
US

IV. Provider business mailing address

1551 W BAY DR STE 103
LARGO FL
33770-2209
US

V. Phone/Fax

Practice location:
  • Phone: 727-588-5243
  • Fax: 727-588-5246
Mailing address:
  • Phone: 727-588-5243
  • Fax: 727-588-5246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number072814
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License NumberME142300
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number072814
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: