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General NPI Number Information
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NPI Number | 1124811302
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Entity Type | Individual
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Provider Name | INDIA TAMAYA FITZ
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Gender | Female
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 1046 RIDGE AVE SW # 4
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City | ATLANTA
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State | GA
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Zip | 30315-1640
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Country | US
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Telephone | 850-755-0018
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Fax | 850-755-0018
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Provider Business Mailing Address
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Address Line | 3416 BLUE JAY DR
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City | TALLAHASSEE
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State | FL
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Zip | 32305-6902
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Country | US
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Telephone | 850-755-0018
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Fax | 850-755-0018
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 11039827
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | GAA-NP003653
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License Number State | GA
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