MEDICARE: DR. TANYA O AGARD M.D.

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	207R00000X	Internal Medicine Physician	ME0075676	FL

General Provider Information

NPI Number	:	1215944731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TANYA O AGARD M.D.

Provider Business Mailing Address
First Line	:	2354 MID PINE CT
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-4603
Country	:	US
Telephone Number	:	407-383-4042
Fax Number	:	321-207-0175

Provider Business Practice Location Address
First Line	:	5703 RED BUG LAKE RD # 341
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-4969
Country	:	US
Telephone Number	:	407-849-7500
Fax Number	:	321-207-0175

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/08/2007

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