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General NPI Number Information
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NPI Number | 1851809859
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Entity Type | Individual
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Provider Name | TARYN NICOLE BOZEMAN HAS
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Gender | Female
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Dates
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Enumeration Date | 01/12/2018
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Last Update Date | 01/12/2018
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Provider Practice Location Address
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Address Line | 210 JUPITER LAKES BLVD. BLDG. 3000 SUITE 202
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City | JUPITER
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State | FL
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Zip | 33458
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Country | US
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Telephone | 561-744-0100
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Fax | 561-744-0173
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Provider Business Mailing Address
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Address Line | 210 JUPITER LAKES BLVD. BLDG. 3000 SUITE 202
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City | JUPITER
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State | FL
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Zip | 33458
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Country | US
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Telephone | 561-744-0100
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Fax | 561-744-0173
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | AS5195
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License Number State | FL
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