Individual
DR. CARLA ROSE TILLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1190 E NINE MILE RD, PENSACOLA, FL 32514-1651
(850) 474-8771
(850) 479-9180
Mailing address
1190 E NINE MILE RD, PENSACOLA, FL 32514-1651
(850) 474-8771
(850) 479-9180
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME78611
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
257288500
—
FL
Enumeration date
07/17/2006
Last updated
10/13/2010
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