Provider Demographics
NPI:1316688260
Name:HOWARD, TARA ANN (DO)
Entity type:Individual
Prefix:MS
First Name:TARA
Middle Name:ANN
Last Name:HOWARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1100 BRICKELL BAY DR APT 49N
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-3565
Mailing Address - Country:US
Mailing Address - Phone:239-560-8082
Mailing Address - Fax:
Practice Address - Street 1:4725 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4603
Practice Address - Country:US
Practice Address - Phone:954-938-3359
Practice Address - Fax:954-492-5790
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2023-12-01
Deactivation Date:2023-08-01
Deactivation Code:
Reactivation Date:2023-08-31
Provider Licenses
StateLicense IDTaxonomies
FLOS20325208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice