Healthcare Provider Details

I. General information

NPI: 1407679723
Provider Name (Legal Business Name): TALA RASSOOL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3021 COMMERCIAL WAY
SPRING HILL FL
34606-3300
US

IV. Provider business mailing address

5400 PINEHURST DR
SPRING HILL FL
34606-3833
US

V. Phone/Fax

Practice location:
  • Phone: 352-688-3379
  • Fax: 352-398-1333
Mailing address:
  • Phone: 727-271-8725
  • Fax: 352-606-2857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11036363
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: