Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | ME121237 | FL |
NPI | 1033405667 |
---|---|
Provider Name | Tammy Marie Berry |
First Address | Sarasota, FL 34239-3509 |
Second Address | Sarasota, FL 34239-3509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2011 |
Last Update Date | 03/04/2017 |