Provider Demographics
NPI:1679722219
Name:DREW, TONYA MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:MARIE
Last Name:DREW
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 S ORLANDO AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4870
Mailing Address - Country:US
Mailing Address - Phone:407-515-2211
Mailing Address - Fax:407-309-5412
Practice Address - Street 1:807 S ORLANDO AVE
Practice Address - Street 2:SUITE C
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4870
Practice Address - Country:US
Practice Address - Phone:407-515-2211
Practice Address - Fax:407-309-5412
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2546552363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
00634OtherGROUP MEDICARE
1346297173OtherGROUP NPI
FL59-1561574OtherTAX ID
FLE1364ZMedicare PIN