Provider Demographics
NPI:1184486722
Name:SAUNDERS, TARVEHALE (RN, LMT)
Entity type:Individual
Prefix:
First Name:TARVEHALE
Middle Name:
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:RN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4855 NW 57TH CT
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-2302
Mailing Address - Country:US
Mailing Address - Phone:954-652-1852
Mailing Address - Fax:
Practice Address - Street 1:242 COMMERCIAL BLVD STE A
Practice Address - Street 2:
Practice Address - City:LAUDERDALE BY THE SEA
Practice Address - State:FL
Practice Address - Zip Code:33308-4496
Practice Address - Country:US
Practice Address - Phone:954-652-1852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9491616163WM1400X
FLMA93531225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)