DR. TARA VANBENNEKOM, DO

Pediatrics

Active Individual
NPI: 1134226699

Practice Address

304 KINGSLEY LAKE DRIVE
SUITE #603
St. Augustine, FL 32092

Phone: (904) 824-5437

Specialties

Specialty Code Primary License
Pediatrics 208000000X Yes OS 8054 (FL)

Frequently Asked Questions

NPI 1134226699 is the National Provider Identifier for DR. TARA VANBENNEKOM, DO, a Pediatrics provider located in St. Augustine, FL. This NPI was enumerated on September 19, 2006.
DR. TARA VANBENNEKOM, DO practices at 304 KINGSLEY LAKE DRIVE, SUITE #603, St. Augustine, FL 32092.

Quick Facts

NPI
1134226699
Type
Individual
Enumerated
Sep 19, 2006
Last Updated
Jul 8, 2007

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