Provider Demographics
NPI:1982832945
Name:TRIBUZIO, BIANCA ASHLEY (DO)
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:ASHLEY
Last Name:TRIBUZIO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:BIANCA
Other - Middle Name:
Other - Last Name:TRIBUZIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:3599 UNIVERSITY BLVD S
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4252
Mailing Address - Country:US
Mailing Address - Phone:904-345-7373
Mailing Address - Fax:904-345-7372
Practice Address - Street 1:3599 UNIVERSITY BLVD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4252
Practice Address - Country:US
Practice Address - Phone:904-345-7373
Practice Address - Fax:904-345-7372
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11675208100000X
FLOS19107208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation