Provider Demographics
NPI:1083062798
Name:ANNA-KAY TENN OD PA
Entity Type:Organization
Organization Name:ANNA-KAY TENN OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA-KAY
Authorized Official - Middle Name:ALICIA
Authorized Official - Last Name:TENN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-805-1811
Mailing Address - Street 1:6452 SHIMMERING SHORES LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34771-9442
Mailing Address - Country:US
Mailing Address - Phone:954-805-1811
Mailing Address - Fax:
Practice Address - Street 1:6452 SHIMMERING SHORES LN
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34771-9442
Practice Address - Country:US
Practice Address - Phone:954-805-1811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-03
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4179152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty