Provider Demographics
NPI:1598239162
Name:SPIEGEL, TANYA MARIE
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:MARIE
Last Name:SPIEGEL
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 1:16311 SW 88TH PL
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-3580
Mailing Address - Country:US
Mailing Address - Phone:305-801-7624
Mailing Address - Fax:305-971-9455
Practice Address - Street 1:16311 SW 88TH PL
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-3580
Practice Address - Country:US
Practice Address - Phone:305-801-7624
Practice Address - Fax:305-971-9455
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant