Provider Demographics
NPI:1013018571
Name:POLITANO, TONYA K (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:TONYA
Middle Name:K
Last Name:POLITANO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 W OAK ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4000
Mailing Address - Country:US
Mailing Address - Phone:407-846-9299
Mailing Address - Fax:
Practice Address - Street 1:1400 W OAK ST
Practice Address - Street 2:SUITE D
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4000
Practice Address - Country:US
Practice Address - Phone:407-846-9299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103448363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical