MEDICARE: JUDE TABBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1003493073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDE TABBA

Provider Business Mailing Address
First Line	:	701 N FEDERAL HWY STE 601
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-2467
Country	:	US
Telephone Number	:	954-482-4747
Fax Number	:	954-301-5939

Provider Business Practice Location Address
First Line	:	701 N FEDERAL HWY STE 601
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-2467
Country	:	US
Telephone Number	:	954-482-4747
Fax Number	:	954-301-5939

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2021
Last Update Date	:	03/24/2025

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Directions to “ JUDE TABBA ” Practice Location

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