Provider Demographics
NPI:1982413480
Name:TURNER, TABITHA
Entity type:Individual
Prefix:
First Name:TABITHA
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TABITHA
Other - Middle Name:
Other - Last Name:BOATWRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5038 BROADSTONE RESERVE CIR
Mailing Address - Street 2:01-258
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-0203
Mailing Address - Country:US
Mailing Address - Phone:404-642-9400
Mailing Address - Fax:
Practice Address - Street 1:5038 BROADSTONE RESERVE CIR
Practice Address - Street 2:01-258
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-0203
Practice Address - Country:US
Practice Address - Phone:404-642-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator