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General NPI Number Information
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NPI Number | 1821208778
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Entity Type | Individual
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Provider Name | JESSICA ELIZABETH TUNIS D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 4301 SUN N LAKE BLVD STE 102
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City | SEBRING
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State | FL
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Zip | 33872-2138
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Country | US
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Telephone | 863-402-3161
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Fax | 863-402-8244
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Provider Business Mailing Address
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Address Line | 8221 DIAMOND COVE CIR
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City | ORLANDO
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State | FL
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Zip | 32836-6053
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Country | US
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Telephone | 908-380-8127
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 2585
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | OS15443
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | OS15443
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License Number State | FL
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