Healthcare Provider Details

I. General information

NPI: 1013365626
Provider Name (Legal Business Name): REBECCA MARIE TUTTLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2016
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S DIXIE HWY STE 200
CORAL GABLES FL
33146-2602
US

IV. Provider business mailing address

1746 TIFFANY PINES CIR W
JACKSONVILLE FL
32225-2591
US

V. Phone/Fax

Practice location:
  • Phone: 904-849-9337
  • Fax:
Mailing address:
  • Phone: 55-866-0443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY12426
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: