MEDICARE: TAMEKIA LATARA FASHAW

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	376J00000X	Homemaker		FL

General Provider Information

NPI Number	:	1447123054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMEKIA LATARA FASHAW

Provider Business Mailing Address
First Line	:	2511 NW 8TH CT APT 2
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-6719
Country	:	US
Telephone Number	:	954-787-1800
Fax Number	:

Provider Business Practice Location Address
First Line	:	2511 NW 8TH CT APT 2
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-6719
Country	:	US
Telephone Number	:	954-787-1800
Fax Number	:

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

Provider Enumeration Date	:	09/29/2025
Last Update Date	:	09/29/2025

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Directions to “ TAMEKIA LATARA FASHAW ” Practice Location

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