Provider Demographics
NPI:1003900952
Name:TINTI, MEREDITH (MD)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:
Last Name:TINTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3627 UNIVERSITY BLVD S STE 305
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4294
Mailing Address - Country:US
Mailing Address - Phone:904-596-0760
Mailing Address - Fax:
Practice Address - Street 1:3627 UNIVERSITY BLVD S STE 500
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-7405
Practice Address - Country:US
Practice Address - Phone:904-596-0760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1196742086S0127X, 208600000X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013389400Medicaid
FLME119674OtherMEDICAL LICENSE
FLHU313ZMedicare PIN
FLHU313YMedicare PIN