Provider Demographics
NPI:1285234856
Name:ANDERSON, TONYA JEAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TONYA
Middle Name:JEAN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4047 SWIFT WAY
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-3306
Mailing Address - Country:US
Mailing Address - Phone:850-447-1010
Mailing Address - Fax:
Practice Address - Street 1:4400 W TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304-1029
Practice Address - Country:US
Practice Address - Phone:850-574-4613
Practice Address - Fax:850-574-3966
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-31
Last Update Date:2020-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS38965183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist