Healthcare Provider Details

I. General information

NPI: 1407557564
Provider Name (Legal Business Name): TARA MARIE SCHINDLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TARA MARIE DUNWOODIE

II. Dates (important events)

Enumeration Date: 03/15/2023
Last Update Date: 06/29/2023
Certification Date: 06/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 KINGSLEY AVE
ORANGE PARK FL
32073-5148
US

IV. Provider business mailing address

1825 KINGSLEY AVE STE 170
ORANGE PARK FL
32073-4478
US

V. Phone/Fax

Practice location:
  • Phone: 904-639-8500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11023783
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: