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General NPI Number Information
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NPI Number | 1760269211
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Entity Type | Organization
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Legal Business Name | TET ANSANM GLOBAL HEALTH INITIATIVE, INC
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Dates
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Enumeration Date | 09/08/2023
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Last Update Date | 09/08/2023
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Provider Practice Location Address
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Address Line | 5840 N ORANGE BLOSSOM TRL
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City | ORLANDO
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State | FL
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Zip | 32810-1025
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Country | US
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Telephone | 845-821-1291
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Fax |
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Provider Business Mailing Address
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Address Line | 5840 N ORANGE BLOSSOM TRL
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City | ORLANDO
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State | FL
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Zip | 32810-1025
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Country | US
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Telephone | 845-821-1291
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARRY BEAUBRUN ANTOINE
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Credential | MD
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Telephone | 845-821-1291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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