Organization
EDWARD D. TRIBUZIO, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD DOMINICK TRIBUZIO M.D. (OWNER/PHYSICIAN)
(904) 261-0643
Entity
Organization
Contact information
Practice address
1340 S 18TH ST, SUITE 204, FERNANDINA BEACH, FL 32034-4799
(904) 261-0643
Mailing address
1340 S 18TH ST, SUITE 204, FERNANDINA BEACH, FL 32034-4799
(904) 261-0643
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
FLME42515
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
067854600
—
FL
Enumeration date
12/08/2011
Last updated
12/08/2011
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