| Doctor Name: | JOHN ANTHONY TAMBASCO |
| NPI Number: | 1770688681 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | SLP |
| License Number: | SA 4906 |
| Business Practice Address: | 3157 N University Dr Suite 103 Pembroke Pines, FL - 330242258 |
| Business Phone Number: | 9544429422 |
| Business Fax Number: | 9544429150 |
| Mailing Address: | 3157 N University Dr, Suite 103 PEMBROKE PINES |
| State: | FL |
| Postal Code: | 330242258 |
| Phone Number: | 9544429422 |
| Fax Number: | 9544429150 |
| NPI Enumeration Date: | 09/14/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA 4906 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |