Healthcare Provider Details

I. General information

NPI: 1285513549
Provider Name (Legal Business Name): TAMARA LACROIX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2025
Last Update Date: 08/30/2025
Certification Date: 08/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9052 MANCHESTER ST
SPRING HILL FL
34606-1323
US

IV. Provider business mailing address

3500 NW 28TH CT
LAUDERDALE LAKES FL
33311-1837
US

V. Phone/Fax

Practice location:
  • Phone: 352-345-6218
  • Fax:
Mailing address:
  • Phone: 561-818-2460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: