Individual
EMILY DURRETT TANZLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7015 A C SKINNER PKWY, BUILDING 100, JACKSONVILLE, FL 32256-6932
(904) 363-2113
(904) 363-2606
Mailing address
7015 A C SKINNER PKWY, SUITE 1, JACKSONVILLE, FL 32256-6932
(904) 363-2113
(904) 363-2606
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
TRN13797
FL
2085R0001X
Radiation Oncology Physician
Primary
ME119132
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012055700
—
FL
01
—
14VS9
BCBS
FL
01
—
374163
AVMED
FL
01
—
4847422
AETNA
FL
Enumeration date
05/29/2009
Last updated
11/17/2014
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