Basic Information
Provider Information
NPI: 1750561007
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUNT
FirstName: TANYA
MiddleName: LEIGH
NamePrefix:  
NameSuffix:  
Credential: A.R.N.P
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 25317
Address2:  
City: TAMPA
State: FL
PostalCode: 336225317
CountryCode: US
TelephoneNumber: 8132860033
FaxNumber: 8132821806
Practice Location
Address1: 1551 CLAY ST
Address2:  
City: WINTER PARK
State: FL
PostalCode: 327895499
CountryCode: US
TelephoneNumber: 4076445371
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/04/2007
LastUpdateDate: 11/01/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/01/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LX0001XARNP9219409FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology

No ID Information.


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