Provider Demographics
NPI:1679167852
Name:SCHILSKY, TAMARA VALENCIA (APRN)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:VALENCIA
Last Name:SCHILSKY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 GRAPE IVY LN
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-2066
Mailing Address - Country:US
Mailing Address - Phone:386-314-3085
Mailing Address - Fax:
Practice Address - Street 1:1055 N DIXIE FWY
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-6201
Practice Address - Country:US
Practice Address - Phone:386-423-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-27
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11011822363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily