Tara Axelrod
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Trinity, FL
NPI 1518669167 · NPPES record last updated Jun 19, 2024
Key facts
- NPI
- 1518669167
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 9330 State Road 54
Trinity, FL 34655-1808 - Phone
- (727) 834-4832
- NPI assigned
- Mar 20, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230714003667 | FL | Order and Referring Only - Diagnostic Radiology |
6002276599 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Interoperability endpoints
- tara.axelrod@hca4.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
9330 State Road 54
Trinity, FL 34655-1808
Mailing address
9330 State Road 54
Trinity, FL 34655-1808
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All providers in Trinity, FL · Student in an Organized Health Care Education/Training Program in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.