Vanbennekom, Tara Lorence

Vanbennekom, Tara Lorence is an individual health care provider with primary practice located at 304 Kingsley Lake Drive Suite #603, St. Augustine FL 32092. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Vanbennekom, Tara Lorence can be contacted via phone (904) 824-5437.

Contact Information

Primary practice address
304 Kingsley Lake Drive Suite #603 St. Augustine FL 32092
Phone: (904) 824-5437
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X OS 8054 Florida

Profile Details

NPI number 1134226699
LBN Legal business name Vanbennekom, Tara Lorence
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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