Provider Demographics
NPI:1083477616
Name:ANTONY, ANNA R
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:R
Last Name:ANTONY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3741 NW 107TH WAY APT 126
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-8110
Mailing Address - Country:US
Mailing Address - Phone:954-644-2160
Mailing Address - Fax:
Practice Address - Street 1:3741 NW 107TH WAY APT 126
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-8110
Practice Address - Country:US
Practice Address - Phone:954-644-2160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program