Healthcare Provider Details

I. General information

NPI: 1760321848
Provider Name (Legal Business Name): ANA GABRIELA TOMPKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 HOSPITAL DR NE
FORT WALTON BEACH FL
32548-5015
US

IV. Provider business mailing address

421 GRIMM LN
HURLBURT FIELD FL
32544-1105
US

V. Phone/Fax

Practice location:
  • Phone: 850-833-7500
  • Fax:
Mailing address:
  • Phone: 865-315-3792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27466
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: