Tara S. Condrey PA
Physician Assistant in Jacksonville, FL(View on Map)
Full Name
Tara Shannon Condrey PA
NPI Number
1083871693
NPI Type
Individual Provider
Gender
Female
Enumeration Date
05/21/2008
Specialties
(Taxonomies)Licenses
State
Florida
License Number
PA9104580
Contact
Information
Purpose
Mailing
Location
Address
11512 LAKE MEAD AVE
11512 LAKE MEAD AVE
City
Jacksonville
Jacksonville
State
FL
FL
Postal Code
32256-9680
32256-9680
Country
US
US
Telephone Number
(904) 419-2054
(904) 419-2054
Identifiers
Identifier
2930951-00
Identifier State
FL
Identifier Issuer
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 03/13/2015