National Provider Identifier Database

TARA L VANBENNEKOM, DO – NPI #1134226699
Pediatrics

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.


Contact Information

TARA L VANBENNEKOM, DO
304 KINGSLEY LAKE DRIVE
SUITE #603
SAINT AUGUSTINE, FL32092
Phone: 904-824-5437
Fax:
Website:
Specialty Taxonomy Code
* Pediatrics 208000000X

* Indicates primary specialty

NPI Profile & details for TARA L VANBENNEKOM

NPI Number 1134226699
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 09/19/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor1 No
Identifiers
  • FL License #: OS 8054
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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