Provider Demographics
NPI:1558591438
Name:TUTWILER, ALANA JANELLE
Entity Type:Individual
Prefix:MS
First Name:ALANA
Middle Name:JANELLE
Last Name:TUTWILER
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 1:785 OAKLEAF PLANTATION PKWY
Mailing Address - Street 2:UNIT 223
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-3533
Mailing Address - Country:US
Mailing Address - Phone:904-210-7619
Mailing Address - Fax:
Practice Address - Street 1:785 OAKLEAF PLANTATION PKWY
Practice Address - Street 2:UNIT 223
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-3533
Practice Address - Country:US
Practice Address - Phone:904-210-7619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-25
Last Update Date:2009-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL811922800Medicaid