Individual provider Active NPI

Tanika Connesero

  • Doula
  • Orlando, FL
National Provider Identifier
1073204202
Registry record updated May 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
Practice address
1317 Edgewater Dr Ste 2019
Orlando, FL 32804-6350
Phone
(214) 513-3047
Fax
(844) 409-1188
NPI assigned
May 18, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Doula 374J00000X Primary

Addresses

Primary practice location

1317 Edgewater Dr Ste 2019
Orlando, FL 32804-6350

Mailing address

200 N Kimball Ave Ste 221
Southlake, TX 76092-6660
Phone (214) 513-3047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1073204202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N KIMBALL AVE STE 221",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926660",
            "telephone_number": "214-513-3047",
            "fax_number": "844-605-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 EDGEWATER DR STE 2019",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328046350",
            "telephone_number": "214-513-3047",
            "fax_number": "844-409-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNESERO",
        "first_name": "TANIKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.