Individual
TANUSHREE ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901
(321) 434-1771
(321) 434-1775
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME84618
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100852500
—
FL
01
—
57758W
MEDICARE
FL
Enumeration date
01/23/2007
Last updated
03/09/2020
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