MEDICARE: DR. GEARLEAN BYRD TARTT ED.D.

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	101YM0800X	Mental Health Counselor	MH 6584	FL

General Provider Information

NPI Number	:	1639291198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEARLEAN BYRD TARTT ED.D.

Provider Business Mailing Address
First Line	:	7380 W SAND LAKE RD
Second Line	:	SUITE 500
City	:	ORLANDO
State	:	FL
Zip	:	32819-5248
Country	:	US
Telephone Number	:	407-654-4266
Fax Number	:	407-859-3477

Provider Business Practice Location Address
First Line	:	7380 W SAND LAKE RD
Second Line	:	SUITE 500
City	:	ORLANDO
State	:	FL
Zip	:	32819-5248
Country	:	US
Telephone Number	:	407-654-4266
Fax Number	:	407-859-3477

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

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	03/30/2015

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