Healthcare Provider Details

I. General information

NPI: 1740206168
Provider Name (Legal Business Name): LILY ANN MARIE TENCZA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N US HIGHWAY 441 STE 553
THE VILLAGES FL
32159-8987
US

IV. Provider business mailing address

1400 N US HIGHWAY 441 STE 553
THE VILLAGES FL
32159-8987
US

V. Phone/Fax

Practice location:
  • Phone: 833-769-3524
  • Fax: 352-350-5297
Mailing address:
  • Phone: 833-769-3524
  • Fax: 352-350-5297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME177325
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301072319
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: