Provider Demographics
NPI:1427294669
Name:AMES, TANYA ELIZABETH (PA-C)
Entity type:Individual
Prefix:MS
First Name:TANYA
Middle Name:ELIZABETH
Last Name:AMES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:1108 GOODLETTE RD N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5451
Mailing Address - Country:US
Mailing Address - Phone:239-434-0303
Mailing Address - Fax:239-262-8730
Practice Address - Street 1:1108 GOODLETTE RD N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5451
Practice Address - Country:US
Practice Address - Phone:239-434-0303
Practice Address - Fax:239-262-8730
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-17
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9104874363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBL051ZMedicare PIN
FLK4948Medicare PIN
FLBL051YMedicare PIN