Individual
MS. TANISHA HINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7001 NW 4TH BLVD, GAINESVILLE, FL 32607-1679
(888) 619-6499
Mailing address
2603 NW 13TH ST # 226, GAINESVILLE, FL 32609-2835
(352) 415-5128
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
H5208165280
FL
174200000X
Meals Provider
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
04/20/2022
Last updated
04/20/2022
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