Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MS. TARA REXANNE ENNIS, MD
Active Sole ProprietorMS. TARA REXANNE ENNIS, MD is a General Surgery healthcare provider located in FORT WALTON BEACH, Florida. NPI 1700961141 is currently active in the NPPES registry. Verify at CMS.
General Surgery · FORT WALTON BEACH, FL
Registration Details
- NPI Number
- 1700961141
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 26, 2006 (19.821904809401 yrs)
- Last Updated
- Jul 7, 2021
- Licenses
-
28214 (AL)ME121048 (FL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1042 MAR WALT DRFORT WALTON BEACH, FL, 325476645Browse FL providers · Browse ZIP 32547
- Phone
- 8508630400
- Fax
- 8508630417
- Primary Specialty
-
General Surgery
208600000X
- Additional Specialty
- General Surgery
Other General Surgery Providers in FORT WALTON BEACH, FL
| Name | Credential | NPI |
|---|---|---|
| DR. JOHN ROBERT BRENT | M.D. | 1609872688 |
| DR. MICHAEL WILLIAM RESTEY | M.D. | 1346222122 |
| DR. RANDALL LOUIS MCKISSACK | M.D. | 1487639621 |
| DR. DAVID W BURKLAND | M.D. | 1467437616 |
| DR. ROBERT LANE ROGERS | M.D. | 1073598983 |
| JOHN CHRISTOFER DALI | M.D. | 1023083177 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.