MEDICARE: TAJUANNA MONIQUE TERRELL

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	171M00000X	Case Manager/Care Coordinator	FL
2	374U00000X	Home Health Aide	FL
3	251S00000X	Community/Behavioral Health Agency	FL

General Provider Information

NPI Number	:	1851277719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAJUANNA MONIQUE TERRELL

Provider Business Mailing Address
First Line	:	17767 TROPICAL COVE DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3670
Country	:	US
Telephone Number	:	813-750-2281
Fax Number	:

Provider Business Practice Location Address
First Line	:	17767 TROPICAL COVE DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3670
Country	:	US
Telephone Number	:	813-750-2281
Fax Number	:

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

Provider Enumeration Date	:	08/14/2025
Last Update Date	:	04/13/2026

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