MEDICARE: MRS. TANISHA INES ZEVALLOS CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife		FL

General Provider Information

NPI Number	:	1154251379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TANISHA INES ZEVALLOS CNM

Provider Business Mailing Address
First Line	:	3067 LEFLORE LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32833-5530
Country	:	US
Telephone Number	:	646-394-1838
Fax Number	:

Provider Business Practice Location Address
First Line	:	661 E ALTAMONTE DR STE 318
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-5103
Country	:	US
Telephone Number	:	407-303-5204
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2026
Last Update Date	:	05/20/2026

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