Dr. Nicholas E Tisdale, MD
Internal Medicine in Vero Beach, FL. Individual provider (NPI-1).
NPI number1962023754
StatusActive
Last updated in NPPESApr 29, 2026
Details
- NPI
- 1962023754
- Entity type
- Individual (NPI-1)
- Name
- Dr. Nicholas E Tisdale
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 3, 2020
- Certification date
- Apr 29, 2026
- Last updated
- Apr 29, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | ME169907 | FL | Yes |
| 207R00000X | Internal Medicine | 22993 | NV | |
| 207R00000X | Internal Medicine | 4301507158 | MI | |
| 207R00000X | Internal Medicine | 35.154509 | OH |
Practice location
1715 37th Pl Fl 2Vero Beach, FL 32960-4508
Phone 772-794-2222 · Fax 772-794-0045
Mailing address
1715 37th Pl Fl 2Vero Beach, FL 32960-4508
Phone 772-794-2222 · Fax 772-794-0045
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