MEDICARE: DR. TANYA D PERICH D.O.

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	208D00000X	General Practice Physician	UO2833	FL
2	207W00000X	Ophthalmology Physician	OS11958	FL

General Provider Information

NPI Number	:	1750661666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TANYA D PERICH D.O.

Provider Business Mailing Address
First Line	:	2020 SEVEN SPRINGS BLVD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-3933
Country	:	US
Telephone Number	:	727-372-1311
Fax Number	:	727-372-7866

Provider Business Practice Location Address
First Line	:	2020 SEVEN SPRINGS BLVD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-3933
Country	:	US
Telephone Number	:	727-372-1311
Fax Number	:	727-372-7866

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

Provider Enumeration Date	:	08/23/2011
Last Update Date	:	11/21/2018

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