Provider Demographics
NPI:1912500406
Name:DAGDA, TONYA LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:LYNN
Last Name:DAGDA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 SEBRING SQ
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-1602
Mailing Address - Country:US
Mailing Address - Phone:863-382-2229
Mailing Address - Fax:863-385-2229
Practice Address - Street 1:410 SEBRING SQ
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1602
Practice Address - Country:US
Practice Address - Phone:863-382-2229
Practice Address - Fax:863-385-2229
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2021-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000945363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health