Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | PT37505 | FL |
NPI | 1043985393 |
---|---|
Provider Name | Mariah Tarabocchia |
First Address | Palm Beach Gardens, FL 33418-3703 |
Second Address | Palm Beach Gardens, FL 33418-3615 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2021 |
Last Update Date | 10/08/2021 |