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Individual

ANTHONY TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1840 ELDRON BLVD SE STE 1, PALM BAY, FL 32909-6871
(321) 312-4580
(321) 914-4053
Mailing address
1840 ELDRON BLVD SE STE 1, PALM BAY, FL 32909-6871
(321) 312-4580
(321) 914-4053

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
171620
NY
207P00000X
Emergency Medicine Physician
Primary
ME120268
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02585871
NY
Enumeration date
10/16/2006
Last updated
03/28/2018
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