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General NPI Number Information
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NPI Number | 1215327853
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Entity Type | Individual
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Provider Name | TARA STRONG HEBURN PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/04/2015
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 2343 AARON ST
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-5305
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Country | US
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Telephone | 855-979-5700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11126
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City | BELFAST
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State | ME
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Zip | 04915-4002
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | PA9108554
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9108554
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9108554
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License Number State | FL
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