| Tanya Mickler, Ph.d, P.a. | |
|
4965 Sw 91st Ter Suite A Gainesville FL 32608-8149 | |
| (352) 337-0551 | |
| (352) 374-2166 |
| Full Name | Tanya Mickler, Ph.d, P.a. |
|---|---|
| Speciality | Psychologist |
| Location | 4965 Sw 91st Ter, Gainesville, Florida |
| Authorized Official Name and Position | Norma Box (OFFICE MANAGER) |
| Authorized Official Contact | 3523370551 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tanya Mickler, Ph.d, P.a. 4965 Sw 91st Ter Suite A Gainesville FL 32608-8149 Ph: (352) 337-0551 | Tanya Mickler, Ph.d, P.a. 4965 Sw 91st Ter Suite A Gainesville FL 32608-8149 Ph: (352) 337-0551 |
| NPI Number | 1356513055 |
|---|---|
| Provider Enumeration Date | 04/02/2008 |
| Last Update Date | 04/02/2008 |
| Medicare PECOS PAC ID | 7012134232 |
|---|---|
| Medicare Enrollment ID | O20140812002496 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356513055 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY5842 (Florida) | Primary |
| Provider Name | Tanya J Mickler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497776587 PECOS PAC ID: 5294952412 Enrollment ID: I20200417000322 |
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