Tatiana Victorovna Ansimova, P.A.

Individual provider Active NPI Surgical Assistant · Sunny Isles Beach, FL

NPI 1962349498 · NPPES record last updated May 1, 2026

Key facts

NPI
1962349498
Entity type
Individual (NPI type 1)
Primary specialty
Surgical Assistant 246ZC0007X
License
25-285 (FL)
Practice address
17720 N Bay Rd Apt 6a
Sunny Isles Beach, FL 33160-2806
Phone
(267) 916-3989
NPI assigned
May 1, 2026
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3077PRMDSpeech-Language Pathologist
25-285FLMDSurgical Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3077 PR
Medical Physician Assistant 363AM0700X 3077 PR
Surgical Physician Assistant 363AS0400X 3077 PR
Surgical Assistant 246ZC0007X 25-285 FL Yes

Addresses

Primary practice location

17720 N Bay Rd Apt 6a
Sunny Isles Beach, FL 33160-2806

Mailing address

17720 N Bay Rd Apt 6a
Sunny Isles Beach, FL 33160-2806
Phone (267) 916-3989

Other providers in Sunny Isles Beach, FL

All providers in Sunny Isles Beach, FL · Surgical Assistant in Florida

Sources for this page

Verify at the official NPI Registry.