Healthcare Provider Details

I. General information

NPI: 1821208778
Provider Name (Legal Business Name): JESSICA ELIZABETH TUNIS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7984 FOREST CITY RD STE 105
ORLANDO FL
32810-2907
US

IV. Provider business mailing address

7984 FOREST CITY RD STE 105
ORLANDO FL
32810-2907
US

V. Phone/Fax

Practice location:
  • Phone: 407-504-2859
  • Fax:
Mailing address:
  • Phone: 407-504-2859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOS15443
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberOS15443
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2585
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: