Provider Demographics
NPI:1508562547
Name:SAINT-FLEUR, TANISHA MICHAELLE
Entity Type:Individual
Prefix:
First Name:TANISHA
Middle Name:MICHAELLE
Last Name:SAINT-FLEUR
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 1:9800 TOUCHTON RD APT 1133
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32246-8294
Mailing Address - Country:US
Mailing Address - Phone:305-746-3683
Mailing Address - Fax:
Practice Address - Street 1:6841 BLANDING BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-4418
Practice Address - Country:US
Practice Address - Phone:904-862-2175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11020607363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner