MEDICARE: DR. ROBI E TAMARGO PSYD

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	103TC0700X	Clinical Psychologist	0810003233	VA
2	103TC0700X	Clinical Psychologist	8914	FL

General Provider Information

NPI Number	:	1710969423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBI E TAMARGO PSYD

Provider Business Mailing Address
First Line	:	13500 SUTTON PARK DR S STE 203
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224-5291
Country	:	US
Telephone Number	:	904-834-7138
Fax Number	:	904-834-7139

Provider Business Practice Location Address
First Line	:	13500 SUTTON PARK DR S STE 203
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32224-5291
Country	:	US
Telephone Number	:	904-834-7138
Fax Number	:	904-834-7139

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

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	04/14/2025

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