Individual
DR. CEDRIC J TANKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 MEDICAL PLAZA DR, LEESBURG, FL 34748-7313
(352) 326-8115
(352) 326-4186
Mailing address
701 MEDICAL PLAZA DR, LEESBURG, FL 34748-7313
(352) 326-8115
(352) 326-4186
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME93733
FL
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
ME93733
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105136300
—
FL
01
—
30061
BLUE CROSS OF FL
FL
Enumeration date
08/30/2006
Last updated
06/12/2023
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