MEDICARE: TENASIA WYNN PSYD

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	103TC0700X	Clinical Psychologist	12987	FL

General Provider Information

NPI Number	:	1487351730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TENASIA WYNN PSYD

Provider Business Mailing Address
First Line	:	2325 COMMERCE PK DR NE APT 4108
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-2663
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5240 BABCOCK ST NE STE 300A
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-4643
Country	:	US
Telephone Number	:	321-914-0113
Fax Number	:

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

Provider Enumeration Date	:	02/07/2023
Last Update Date	:	11/01/2025

Similar Medicare Providers

1144947177 — YOUR HEASLTH & YOUR CHOICE INC
Practice Location Address:

5057 BRECKENRIDGE PL APT 19
WEST PALM BCH, FL
33417-4643

Practice Phone: 561-797-6714
Practice Fax:

1093886145 — DR. HALEY L P OWEN MD
Practice Location Address:

6043 N BERKELEY BLVD
WHITEFISH BAY, WI
53217-4643

Practice Phone: 414-507-8844
Practice Fax:

1104210012 — ERROL GORDON
Practice Location Address:

2032 BAY RIDGE AVE , APT 4
BROOKLYN, NY
11204-4643

Practice Phone: 917-648-7303
Practice Fax:

1457110983 — CYNTHIA SIERRA LPC
Practice Location Address:

4643 BRANCHING BAY
SAN ANTONIO, TX
78259-2286

Practice Phone: 210-863-3555
Practice Fax:

1114878626 — SHANGRI-LA ALF 868 LLC
Practice Location Address:

868 RIVIERA DR NE
PALM BAY, FL
32905-4438

Practice Phone: 321-432-0675
Practice Fax:

1588089098 — TIFFANY JAMES APRN
Practice Location Address:

4680 LIPSCOMB ST NE STE 10B
PALM BAY, FL
32905-2928

Practice Phone: 321-364-3758
Practice Fax: 833-635-8722

Directions to “ TENASIA WYNN PSYD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.