Healthcare Provider Details

I. General information

NPI: 1295197366
Provider Name (Legal Business Name): JEROME JOEL TUITT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2016
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HEALTH PARK BLVD STE 300
ST AUGUSTINE FL
32086
US

IV. Provider business mailing address

400 HEALTH PARK BLVD STE 300
ST AUGUSTINE FL
32086-5784
US

V. Phone/Fax

Practice location:
  • Phone: 904-819-4085
  • Fax: 904-819-5056
Mailing address:
  • Phone: 904-819-4085
  • Fax: 904-819-5156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD26651
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD26651
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD26651
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberC1218
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC1218
License Number StateKY
# 6
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME139998
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: