Provider Demographics
NPI:1740468636
Name:TINSLEY-DALTON, INEZ MARIA (MD)
Entity type:Individual
Prefix:
First Name:INEZ
Middle Name:MARIA
Last Name:TINSLEY-DALTON
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 1:620 CRASSAS DR
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903-4701
Mailing Address - Country:US
Mailing Address - Phone:321-537-9807
Mailing Address - Fax:321-773-3518
Practice Address - Street 1:2060 A1A HWY STE 307
Practice Address - Street 2:
Practice Address - City:INDIAN HARBOUR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3596
Practice Address - Country:US
Practice Address - Phone:321-537-9807
Practice Address - Fax:321-773-3518
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME699192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry