Healthcare Provider Details

I. General information

NPI: 1720170467
Provider Name (Legal Business Name): ANA M TAMAYO MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2472 N UNIVERSITY DR
PEMBROKE PINES FL
33024
US

IV. Provider business mailing address

2472 N UNIVERSITY DR
PEMBROKE PINES FL
33024
US

V. Phone/Fax

Practice location:
  • Phone: 954-436-1300
  • Fax: 954-431-6855
Mailing address:
  • Phone: 954-436-1300
  • Fax: 954-431-6855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME38278
License Number StateFL

VIII. Authorized Official

Name: ANA M TAMAYO
Title or Position: PRESIDENT
Credential: MD
Phone: 954-436-1300