Edward D. Tribuzio, M.D., P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

FLME42515 Issued in FL

Legal business name

EDWARD D. TRIBUZIO, M.D., P.A.

Practice address

1340 S 18TH St
Suite 204
Fernandina Beach, FL 32034-4799

Phone

(904) 261-0643

NPI assigned

Dec 8, 2011

Last updated

Dec 8, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edward Dominick Tribuzio, M.D.

Title

Owner/Physician

Phone

(904) 261-0643

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323302400000",
    "number": "1891063509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 S 18TH ST",
            "address_2": "SUITE 204",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344799",
            "telephone_number": "904-261-0643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 S 18TH ST",
            "address_2": "SUITE 204",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344799",
            "telephone_number": "904-261-0643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD D. TRIBUZIO, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-08",
        "last_updated": "2011-12-08",
        "status": "A",
        "authorized_official_last_name": "TRIBUZIO",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "DOMINICK",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "904-261-0643",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "FLME42515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067854600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.