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NPI Code Detail

MEDICARE: DR. EDWARD DOMINICK TRIBUZIO M.D.

MEDICARE: DR. EDWARD DOMINICK TRIBUZIO M.D.
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
1207Q00000XFamily Medicine PhysicianME42515FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NG830OTHERFLMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
345033OTHERFLBCBS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174501571
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD DOMINICK TRIBUZIO M.D.
Provider Business Mailing Address
First Line : 2675 WINKLER AVE FL 2
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-9342
Country : US
Telephone Number : 877-856-3774
Fax Number : 239-599-2612
Provider Business Practice Location Address
First Line : 1132 S 14TH ST
Second Line :
City : FERNANDINA BEACH
State : FL
Zip : 32034-2920
Country : US
Telephone Number : 904-432-3061
Fax Number : 904-432-3062
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2006
Last Update Date : 06/09/2023

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Directions to “ DR. EDWARD DOMINICK TRIBUZIO M.D.” Practice Location

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