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
—
—
Other
Enumeration date
05/13/2008
Last updated
07/28/2008
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