Provider Demographics
NPI:1124337332
Name:TENIS, VEDIA
Entity type:Individual
Prefix:MS
First Name:VEDIA
Middle Name:
Last Name:TENIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VEDIA
Other - Middle Name:
Other - Last Name:BAYRAKTAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4433 CARAMBOLA CIR S
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33066-2552
Mailing Address - Country:US
Mailing Address - Phone:646-247-2096
Mailing Address - Fax:
Practice Address - Street 1:7016 BERACASA WAY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3447
Practice Address - Country:US
Practice Address - Phone:561-391-8770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI3005300183500000X
FLPS51739183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist