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General NPI Number Information
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NPI Number | 1346899143
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Entity Type | Individual
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Provider Name | GREGORY TAMBIO
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Gender | Male
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 8701 MAITLAND SUMMIT BLVD
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City | ORLANDO
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State | FL
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Zip | 32810-5915
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Country | US
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Telephone | 407-916-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 2510 KALEY WOOD CT
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City | SAINT CLOUD
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State | FL
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Zip | 34772-8866
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Country | US
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Telephone | 407-232-4016
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT20169
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License Number State | FL
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