Provider Demographics
NPI:1679054365
Name:HUNTER, TAVAJAH BRANDON (MS ED)
Entity Type:Individual
Prefix:MR
First Name:TAVAJAH
Middle Name:BRANDON
Last Name:HUNTER
Suffix:
Gender:M
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11951 NW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-1503
Mailing Address - Country:US
Mailing Address - Phone:305-847-1111
Mailing Address - Fax:
Practice Address - Street 1:1000 N HIATUS RD STE 161
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3097
Practice Address - Country:US
Practice Address - Phone:954-333-8787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health