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Mrs. Tamara Grigaltchik
Military Health Care Provider in North Port, Florida
NPI 1265762017

Tamara Grigaltchik is a Military Health Care Provider based in North Port, FL. Tamara Grigaltchik practices in North Port, FL. The NPI Number for Tamara Grigaltchik is 1265762017 and holds a License No. 6906380 (Florida).

The current practice location address for Tamara Grigaltchik is 12105 Madrid Ave, North Port, FL and can be reached out via phone at 941-423-0019 and via fax at 941-423-0019.

Location: 12105 Madrid Ave, North Port, FL, 34287-1123
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1265762017
Provider Name
Tamara Grigaltchik
Credential
Provider Entity Type
Individual
Gender
Female
Address
12105 Madrid Ave, North Port, FL, 34287-1123
Phone Number
941-423-0019
Fax Number
941-423-0019
Provider Enumeration Date
12/29/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
12105 Madrid Ave
City
North Port
State
Florida
Zip
34287-1123
Phone Number
941-423-0019
Fax Number
941-423-0019
person
Provider Business Mailing Address Details
Address
12105 Madrid Ave
City
North Port
State
Florida
Zip
34287-1123
Phone Number
941-423-0019
Fax Number
941-423-0019
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
6906380 (Florida)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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