Provider Demographics
NPI:1275729857
Name:TAMAYO, ANA M (MD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:M
Last Name:TAMAYO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2472 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3624
Mailing Address - Country:US
Mailing Address - Phone:954-436-1300
Mailing Address - Fax:954-431-6855
Practice Address - Street 1:2472 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3624
Practice Address - Country:US
Practice Address - Phone:954-436-1300
Practice Address - Fax:954-431-6855
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38278207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL94079Medicare PIN