Healthcare Provider Details

I. General information

NPI: 1710620166
Provider Name (Legal Business Name): TAMARI PIOMBINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 04/15/2022
Certification Date: 04/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1371 CHAPARRAL LN
WINTER SPRINGS FL
32708-4852
US

IV. Provider business mailing address

1371 CHAPARRAL LN
WINTER SPRINGS FL
32708-4852
US

V. Phone/Fax

Practice location:
  • Phone: 407-219-7352
  • Fax:
Mailing address:
  • Phone: 407-219-7352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number22336
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: