Provider Demographics
NPI:1992191407
Name:ALIYEVA, TATYANA (MD)
Entity Type:Individual
Prefix:
First Name:TATYANA
Middle Name:
Last Name:ALIYEVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 LINTON BLVD STE F107
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-6506
Mailing Address - Country:US
Mailing Address - Phone:561-498-5660
Mailing Address - Fax:561-498-0753
Practice Address - Street 1:4800 LINTON BLVD STE F107
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6506
Practice Address - Country:US
Practice Address - Phone:561-498-5660
Practice Address - Fax:561-498-0753
Is Sole Proprietor?:No
Enumeration Date:2015-04-10
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME138306207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine