Healthcare Provider Details

I. General information

NPI: 1205832565
Provider Name (Legal Business Name): TANYA N SCHRUMPF DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TANYA DEUKMEDJIAN DC

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8043 SPYGLASS HILL RD STE 102
MELBOURNE FL
32940-8563
US

IV. Provider business mailing address

8043 SPYGLASS HILL RD STE 102
MELBOURNE FL
32940-8563
US

V. Phone/Fax

Practice location:
  • Phone: 321-757-6899
  • Fax: 321-757-6859
Mailing address:
  • Phone: 321-757-6899
  • Fax: 321-757-6859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH9229
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11006386
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: