Doctor Name: | DR. TARA LORENCE VANBENNEKOM |
NPI Number: | 1134226699 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DO |
License Number: | OS 8054 |
Business Practice Address: | 304 Kingsley Lake Drive Suite #603 St. Augustine, FL - 32092 |
Business Phone Number: | 9048245437 |
Business Fax Number: | |
Mailing Address: | 201 St. Johns Forest Blvd, JACKSONVILLE |
State: | FL |
Postal Code: | 32259 |
Phone Number: | 9048245796 |
Fax Number: | |
NPI Enumeration Date: | 09/19/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208000000X |
License Number: | OS 8054 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Pediatrics |
Taxonomy Specialization: | |
Taxonomy Definition: | A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |