Individual provider Active NPI

Zeda Perez Tully

  • Nurse Practitioner
  • Indialantic, FL
National Provider Identifier
1063388395
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11041165 Issued in FL
Practice address
140 6TH Ave
Indialantic, FL 32903-3204
Phone
(321) 312-3501
NPI assigned
Oct 14, 2025
Last updated
Feb 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11041165 FL Primary

Addresses

Primary practice location

140 6TH Ave
Indialantic, FL 32903-3204

Mailing address

6753 Huntleigh Hammock Rd
Harmony, FL 34773-6137

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11041165FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Tree Interventional Pain Management, PLLC Interventional Pain Medicine PastSince Oct 21, 2025 Accepting new patients
Cardiac Clinic of Sunil M. Kakkar, M.D, P.a PastSince Oct 21, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1760400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1063388395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6753 HUNTLEIGH HAMMOCK RD",
            "city": "HARMONY",
            "state": "FL",
            "postal_code": "347736137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 6TH AVE",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329033204",
            "telephone_number": "321-312-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ TULLY",
        "first_name": "ZEDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-14",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11041165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indialantic, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.