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General NPI Number Information
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NPI Number | 1699379545
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Entity Type | Individual
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Provider Name | IMAN TUNALI RDH
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Gender | Female
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Dates
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Enumeration Date | 11/22/2020
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Last Update Date | 11/22/2020
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Provider Practice Location Address
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Address Line | 3385 S US HIGHWAY 17/92 STE 221
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City | CASSELBERRY
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State | FL
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Zip | 32707-2916
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Country | US
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Telephone | 407-831-2255
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Fax |
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Provider Business Mailing Address
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Address Line | 2514 TWILIGHT DR
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City | ORLANDO
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State | FL
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Zip | 32825-7414
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Country | US
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Telephone | 407-655-9059
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH24870
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License Number State | FL
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