MEDICARE: MISS TONYA K POLITANO P.A.-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA9103448	FL

General Provider Information

NPI Number	:	1013018571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS TONYA K POLITANO P.A.-C

Provider Business Mailing Address
First Line	:	2155 NOLTE RD
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34772-8762
Country	:	US
Telephone Number	:	407-846-9247
Fax Number	:

Provider Business Practice Location Address
First Line	:	2155 NOLTE RD
Second Line	:
City	:	SAINT CLOUD
State	:	FL
Zip	:	34772-8762
Country	:	US
Telephone Number	:	407-846-9247
Fax Number	:	407-846-4430

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	09/08/2024

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