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General NPI Number Information
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NPI Number | 1114798774
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Entity Type | Individual
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Provider Name | TARAH CZYZEWSKI
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Gender | Female
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Dates
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Enumeration Date | 01/12/2024
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 5741 BEE RIDGE RD STE 450
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City | SARASOTA
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State | FL
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Zip | 34233-5081
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Country | US
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Telephone | 941-214-2864
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Fax |
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Provider Business Mailing Address
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Address Line | 6715 LOCKWOOD RIDGE RD APT 416
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City | SARASOTA
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State | FL
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Zip | 34243-3698
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Country | US
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Telephone | 941-724-5426
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11030590
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License Number State | FL
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