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General NPI Number Information
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NPI Number | 1588906101
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Entity Type | Individual
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Provider Name | TANYA LYNN SYMONETTE D.O.M.
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Gender | Female
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Dates
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Enumeration Date | 03/21/2013
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Last Update Date | 04/29/2016
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Provider Practice Location Address
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Address Line | 4505 W FLAGLER ST SUITE 202
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City | CORAL GABLES
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State | FL
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Zip | 33134-1500
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Country | US
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Telephone | 786-364-7660
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Fax |
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Provider Business Mailing Address
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Address Line | 1642 SW 18TH AVE
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City | MIAMI
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State | FL
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Zip | 33145-1467
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Country | US
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Telephone | 954-290-1974
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Fax |
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP 3235
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License Number State | FL
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