Individual
TYLA RISUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 697-3600
Mailing address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 697-3600
(904) 687-3927
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
—
—
Other
Enumeration date
04/22/2024
Last updated
04/22/2024
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