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NPI Code Detail

MEDICARE: DR. MILTON FREDERICK TYLER IV MD

MEDICARE: DR. MILTON FREDERICK TYLER IV MD
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
1390200000XStudent in an Organized Health Care Education/Training Program

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
129161OTHERFLFLORIDA BOARD OF MEDICINE

General Provider Information

NPI Number : 1669036943
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MILTON FREDERICK TYLER IV MD
Provider Business Mailing Address
First Line : 4777 E GALBRAITH RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45236-2814
Country : US
Telephone Number : 321-841-5142
Fax Number : 407-648-3686
Provider Business Practice Location Address
First Line : 4777 E GALBRAITH RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45236-2814
Country : US
Telephone Number : 513-686-5469
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2019
Last Update Date : 06/23/2020

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