Provider Demographics
NPI:1407636707
Name:TANIS, NADINE
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:TANIS
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 1:12864 BISCAYNE BLVD # 318
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2007
Mailing Address - Country:US
Mailing Address - Phone:786-468-6169
Mailing Address - Fax:786-953-6577
Practice Address - Street 1:445 NW 135TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-3844
Practice Address - Country:US
Practice Address - Phone:786-468-6169
Practice Address - Fax:786-953-6577
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula