Provider Demographics
NPI:1376104042
Name:FLORIMON ALMANZAR, TANIA MARIELL (MD, MPH)
Entity Type:Individual
Prefix:
First Name:TANIA
Middle Name:MARIELL
Last Name:FLORIMON ALMANZAR
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 W 106TH ST APT 1C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-3864
Mailing Address - Country:US
Mailing Address - Phone:718-427-6909
Mailing Address - Fax:
Practice Address - Street 1:3332 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-8732
Practice Address - Country:US
Practice Address - Phone:212-694-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY318293208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty