Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Tara Lorence Vanbennekom, DO

Individual provider Pediatrics Physician · NPI 1134226699

Dr. Tara Lorence Vanbennekom, DO is a Pediatrics Physician in St Augustine, Florida. Licensed in Florida. Registered with an NPI since 2006.

Licensed in
FL
In the registry since
2006
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

304 Kingsley Lake Dr Ste #603
St Augustine, FL 32092
Phone: (904) 824-5437
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence OS 8054 (FL)

Record details

NPI number1134226699
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedSeptember 19, 2006
Last updated in NPPESJuly 8, 2007
Mailing address201 St. Johns Forest Blvd, Jacksonville, FL 32259

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