| Doctor Name: | MS. TARA REXANNE HARDEN |
| NPI Number: | 1700961141 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 28214 |
| Business Practice Address: | 1775 Lewis Turner Blvd Suite 101 Fort Walton Beach, FL - 325471267 |
| Business Phone Number: | 8508630400 |
| Business Fax Number: | 8508630417 |
| Mailing Address: | 1775 Lewis Turner Blvd, Suite 101 FORT WALTON BEACH |
| State: | FL |
| Postal Code: | 325471267 |
| Phone Number: | 8508630400 |
| Fax Number: | 8508630417 |
| NPI Enumeration Date: | 10/26/2006 |
| NPI Last Update Date: | 08/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 28214 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |