Provider Demographics
NPI:1942236070
Name:TANONA, ANTHONY WILLIAM (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:WILLIAM
Last Name:TANONA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17501 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4802
Mailing Address - Country:US
Mailing Address - Phone:305-933-5733
Mailing Address - Fax:305-933-5233
Practice Address - Street 1:17501 BISCAYNE BLVD
Practice Address - Street 2:SUITE 450
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33160-4802
Practice Address - Country:US
Practice Address - Phone:305-933-5733
Practice Address - Fax:305-933-5233
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7207103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11581680OtherCAQH PROVIDER ID