Provider Demographics
NPI:1386152684
Name:WARD, TAMORA LEA (LMT)
Entity type:Individual
Prefix:MS
First Name:TAMORA
Middle Name:LEA
Last Name:WARD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8253 OMAHA CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-5155
Mailing Address - Country:US
Mailing Address - Phone:352-515-8811
Mailing Address - Fax:352-515-0005
Practice Address - Street 1:8253 OMAHA CIR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-5155
Practice Address - Country:US
Practice Address - Phone:352-515-8811
Practice Address - Fax:352-515-0005
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-21
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA55561225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist