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General NPI Number Information
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NPI Number | 1861024515
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Entity Type | Organization
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Legal Business Name | ANOTHER WAY 2 LLC
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Dates
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Enumeration Date | 02/11/2020
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Last Update Date | 02/11/2020
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Provider Practice Location Address
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Address Line | 3840 LEMON ST
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City | RIVERSIDE
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State | CA
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Zip | 92501-3693
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Country | US
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Telephone | 954-937-2944
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Fax |
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Provider Business Mailing Address
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Address Line | 1835 E HALLANDALE BEACH BLVD # 9127
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009-4619
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Country | US
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Telephone | 954-937-2944
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ZANDRA BERNETA TUTT
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Credential | MD
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Telephone | 954-937-2944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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