Healthcare Provider Details

I. General information

NPI: 1689011108
Provider Name (Legal Business Name): TANYA NICOLE BEDWARD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2013
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13655 PASTEUR BLVD
PALM BEACH GARDENS FL
33418-7392
US

IV. Provider business mailing address

1155 S CONGRESS AVE STE C
PALM SPRINGS FL
33406-5114
US

V. Phone/Fax

Practice location:
  • Phone: 728-236-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME147931
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: