Provider Demographics
NPI:1619233657
Name:DELIMA-TOKARZ, THAYANNE CAMARGO (DO)
Entity Type:Individual
Prefix:
First Name:THAYANNE
Middle Name:CAMARGO
Last Name:DELIMA-TOKARZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:THAYANNE
Other - Middle Name:CARMARGO
Other - Last Name:DELIMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:14850 S SPUR DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-2111
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1545 HARBECK RD
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5605
Practice Address - Country:US
Practice Address - Phone:541-476-2373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO27812084P0800X
FLOS145992084P0800X
TN30722084P0800X
ORDO1869112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry