Provider Demographics
NPI:1245247014
Name:MCCARUS, TAMBERLY FORD (MD)
Entity type:Individual
Prefix:DR
First Name:TAMBERLY
Middle Name:FORD
Last Name:MCCARUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 CELEBRATION PL FL 2
Mailing Address - Street 2:
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-4606
Mailing Address - Country:US
Mailing Address - Phone:407-303-4190
Mailing Address - Fax:407-303-4191
Practice Address - Street 1:380 CELEBRATION PL FL 2
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-4606
Practice Address - Country:US
Practice Address - Phone:407-303-4190
Practice Address - Fax:407-303-4191
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME54599207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258497200Medicaid
FLE91918Medicare UPIN