Individual
DEBORAH TISDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1843 NW 96TH AVE, PLANTATION, FL 33322-5626
(954) 472-2512
Mailing address
1843 NW 96TH AVE, PLANTATION, FL 33322-5626
(954) 472-2512
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
00016984
AL
Other
Enumeration date
11/20/2006
Last updated
08/17/2007
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