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General NPI Number Information
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NPI Number | 1568434975
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Entity Type | Individual
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Provider Name | JONATHAN MICHAEL TARRASH M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 7015 BERACASA WAY STE 102
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City | BOCA RATON
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State | FL
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Zip | 33433-3453
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Country | US
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Telephone | 561-295-3900
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Fax | 561-431-8288
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Provider Business Mailing Address
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Address Line | 10637 MENDOCINO LN
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City | BOCA RATON
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State | FL
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Zip | 33428-1229
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Country | US
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Telephone | 561-866-0370
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | ME60188
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME60188
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License Number State | FL
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