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Organization
TANYA ITANI TAIVAL DO LLC
Active
Organization
TANYA ITANI TAIVAL DO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TANYA ITANI TAIVAL D.O. (PROVIDER)
(321) 269-0748
Entity
Organization
Contact information
Practice address
875 CENTURY MEDICAL DR, TITUSVILLE, FL 32796-2142
(321) 269-0748
(321) 383-2424
Mailing address
875 CENTURY MEDICAL DR, TITUSVILLE, FL 32796-2142
(321) 269-0748
(321) 383-2424
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
05/13/2008
Last updated
07/28/2008
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