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NPI Code Detail

MEDICARE: ZEDA PEREZ TULLY

MEDICARE: ZEDA PEREZ TULLY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner11041165FL

General Provider Information

NPI Number : 1063388395
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZEDA PEREZ TULLY
Provider Business Mailing Address
First Line : 6753 HUNTLEIGH HAMMOCK RD
Second Line :
City : HARMONY
State : FL
Zip : 34773-6137
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 140 6TH AVE
Second Line :
City : INDIALANTIC
State : FL
Zip : 32903-3204
Country : US
Telephone Number : 321-312-3501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2025
Last Update Date : 02/19/2026

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Directions to “ ZEDA PEREZ TULLY ” Practice Location

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