Provider Demographics
NPI:1114575727
Name:TAMNEY, VONICA ERVIN
Entity Type:Individual
Prefix:
First Name:VONICA
Middle Name:ERVIN
Last Name:TAMNEY
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:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-0012
Mailing Address - Country:US
Mailing Address - Phone:813-927-7500
Mailing Address - Fax:
Practice Address - Street 1:4753 TAMNEY LN
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-3749
Practice Address - Country:US
Practice Address - Phone:813-927-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider