Individual
TAYISHA VILCEUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
6072 DOCTORS PARK, MILTON, FL 32570
(850) 626-5447
Mailing address
6072 DOCTORS PARK, MILTON, FL 32570-5072
(850) 626-5447
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME128853
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2012
Last updated
07/16/2018
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