Provider Demographics
NPI:1447505425
Name:BEVINGTON, TANIA L (APRN)
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:L
Last Name:BEVINGTON
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 1:700 W HILLSBORO BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-1612
Mailing Address - Country:US
Mailing Address - Phone:813-253-9962
Mailing Address - Fax:
Practice Address - Street 1:700 W HILLSBORO BLVD STE 203
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-1612
Practice Address - Country:US
Practice Address - Phone:813-253-9962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9295681363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health