Individual
MS. TATIYANA ANISIMOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2605 CASA DR, NEW PORT RICHEY, FL 34655-2235
(304) 550-8040
Mailing address
7840 PUTNAM CIR, NEW PORT RICHEY, FL 34655-2739
(813) 598-5058
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
FL
Other
Enumeration date
03/05/2020
Last updated
03/05/2020
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