Provider Demographics
NPI:1295445914
Name:HARVEY, TANIA SOPHIA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:SOPHIA
Last Name:HARVEY
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2869 WILSHIRE DR STE 203
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-3282
Mailing Address - Country:US
Mailing Address - Phone:407-903-9696
Mailing Address - Fax:407-903-9696
Practice Address - Street 1:2869 WILSHIRE DR STE 203
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-3282
Practice Address - Country:US
Practice Address - Phone:407-903-9696
Practice Address - Fax:407-903-9696
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11021632363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health