Provider Demographics
NPI:1346571999
Name:TENN, ANNA-KAY ALICIA (OD)
Entity Type:Individual
Prefix:DR
First Name:ANNA-KAY
Middle Name:ALICIA
Last Name:TENN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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 1:4200 CONROY RD STE 269
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-2441
Practice Address - Country:US
Practice Address - Phone:407-903-1018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4179152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist