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General NPI Number Information
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NPI Number | 1194670570
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Entity Type | Individual
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Provider Name | TIARA GOOCH
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Gender | Female
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 1891 CAPITAL CIR NE STE 2
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4486
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Country | US
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Telephone | 850-877-8855
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Fax |
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Provider Business Mailing Address
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Address Line | 2738 W THARPE ST APT 303
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City | TALLAHASSEE
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State | FL
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Zip | 32303-8643
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT44439
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License Number State | FL
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