Healthcare Provider Details

I. General information

NPI: 1447140918
Provider Name (Legal Business Name): MYSHA VERONICA TONGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5840 RED BUG LAKE RD # 2060
WINTER SPRINGS FL
32708-5011
US

IV. Provider business mailing address

5840 RED BUG LAKE RD # 2060
WINTER SPRINGS FL
32708-5011
US

V. Phone/Fax

Practice location:
  • Phone: 954-544-1734
  • Fax:
Mailing address:
  • Phone: 954-544-1734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW27341
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: