| Tara Liske, APRN | |
| 109 W Wall St, Frostproof, FL 33843-2043 | |
| (866) 234-8534 | |
| Not Available | 
| Full Name | Tara Liske | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Family | 
| Location | 109 W Wall St, Frostproof, Florida | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1316672975 | NPI | - | NPPES | 
| 115868500 | Medicaid | FL | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 11020765 (Florida) | Primary | 
| Entity Name | Central Florida Health Care Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1467449660 PECOS PAC ID: 0143127951 Enrollment ID: O20031218000228 | 
| Entity Name | Tampa Family Health Centers Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1356347413 PECOS PAC ID: 1254243769 Enrollment ID: O20110105001043 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Tara Liske, APRN 47 5th St Nw, Winter Haven, FL 33881-4672 Ph: (866) 234-8534 | Tara Liske, APRN 109 W Wall St, Frostproof, FL 33843-2043 Ph: (866) 234-8534 | 
| Jennifer Shaw, ARNP, FNP-C, RNC-OB Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 109 W Wall St, Frostproof, FL 33843 Phone: 866-234-8534 | |
| Amanda L Blitz, A.R.N.P Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 109 W Wall St, Frostproof, FL 33843 Phone: 863-635-4891 Fax: 863-635-7613 | |
| Stephanie Lynn Smith, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 109 W Wall St, Frostproof, FL 33843 Phone: 863-635-4891 | |
| Teresa A Lyle, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 109 W Wall St, Frostproof, FL 33843 Phone: 863-635-4891 Fax: 863-635-3545 |