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NPI Code Detail

MEDICARE: MS. TANYA B. KEELEY P.A.-C.

MEDICARE: MS. TANYA B. KEELEY 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
1363A00000XPhysician AssistantPA9101504FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Y00S1OTHERFLBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558307066
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TANYA B. KEELEY P.A.-C.
Provider Business Mailing Address
First Line : PO BOX 55342
Second Line :
City : SAINT PETERSBURG
State : FL
Zip : 33732-5342
Country : US
Telephone Number : 727-498-0629
Fax Number :
Provider Business Practice Location Address
First Line : 1200 7TH AVE N
Second Line :
City : SAINT PETERSBURG
State : FL
Zip : 33705-1300
Country : US
Telephone Number : 727-825-1100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 08/22/2016

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