Provider Demographics
NPI:1386872877
Name:DOIDGE, TANYA ELIZABETH (PT)
Entity type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:ELIZABETH
Last Name:DOIDGE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7749 NORMANDY BLVD STE 147
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32221-7658
Mailing Address - Country:US
Mailing Address - Phone:904-786-5576
Mailing Address - Fax:904-786-9907
Practice Address - Street 1:7749 NORMANDY BLVD STE 147
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32221-7658
Practice Address - Country:US
Practice Address - Phone:904-786-5576
Practice Address - Fax:904-786-9907
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 24763225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist