Provider Demographics
NPI:1124223581
Name:ENSLEY, TYLER CHARLES (DO)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:CHARLES
Last Name:ENSLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 151368
Mailing Address - Street 2:CAPE CORAL EMERGENCY PHYSICIANS, LLC
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33915
Mailing Address - Country:US
Mailing Address - Phone:239-424-3513
Mailing Address - Fax:239-424-4039
Practice Address - Street 1:CAPE CORAL HOSPITAL
Practice Address - Street 2:636 DEL PRADO BLVD
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990
Practice Address - Country:US
Practice Address - Phone:239-424-3513
Practice Address - Fax:239-424-4039
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-17
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS15967207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine