Organization
TNTMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA N TILLIS MD (OWNER/ PROVIDER)
(904) 345-3473
Entity
Organization
Contact information
Practice address
3890 DUNN AVE, SUITE 902, JACKSONVILLE, FL 32218-6428
(904) 345-3473
(904) 208-5892
Mailing address
3890 DUNN AVE, SUITE 902, JACKSONVILLE, FL 32218-6428
(904) 345-3473
(904) 208-5892
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME64518
FL
Other
Enumeration date
06/23/2014
Last updated
06/23/2014
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