Organization
GILMAN R TYLER MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MARTINEZ (BILLING)
(813) 496-1075
Entity
Organization
Contact information
Practice address
602 S AUDUBON AVE, STE A, TAMPA, FL 33609-4217
(813) 877-1415
Mailing address
602 S AUDUBON AVE, STE A, TAMPA, FL 33609-4217
(813) 877-1415
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME48678
FL
2086S0129X
Vascular Surgery Physician
ME48678
FL
Other
Enumeration date
03/09/2009
Last updated
12/14/2010
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