Provider Demographics
NPI:1548539588
Name:TANYI, EL AGATHE ASOPO (ARNP)
Entity type:Individual
Prefix:
First Name:EL AGATHE
Middle Name:ASOPO
Last Name:TANYI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1747 FORT SMITH BLVD
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-3728
Mailing Address - Country:US
Mailing Address - Phone:202-834-7722
Mailing Address - Fax:
Practice Address - Street 1:1747 FORT SMITH BLVD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725-3728
Practice Address - Country:US
Practice Address - Phone:202-834-7722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9275188363LP0808X
FLARNP9275188363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner