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General NPI Number Information
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NPI Number | 1083062798
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Entity Type | Organization
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Legal Business Name | ANNA-KAY TENN OD PA
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Dates
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Enumeration Date | 06/03/2016
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Last Update Date | 02/21/2024
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Provider Practice Location Address
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Address Line | 6452 SHIMMERING SHORES LN
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City | SAINT CLOUD
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State | FL
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Zip | 34771-9442
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Country | US
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Telephone | 954-805-1811
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Fax |
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Provider Business Mailing Address
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Address Line | 6452 SHIMMERING SHORES LN
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City | SAINT CLOUD
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State | FL
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Zip | 34771-9442
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Country | US
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Telephone | 954-805-1811
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. ANNA-KAY ALICIA TENN
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Credential | OD
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Telephone | 954-805-1811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC4179
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License Number State | FL
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