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Ms. Tara Rexanne Ennis, MD
Surgery Physician in Fort Walton Beach, Florida
NPI 1700961141

Tara Rexanne Ennis is a Surgery Physician based in Fort Walton Beach, FL. Tara Rexanne Ennis practices in Fort Walton Beach, FL and has the professional credentials of MD. The NPI Number for Tara Rexanne Ennis is 1700961141 and holds a License No. 28214 (Florida).

The current practice location address for Tara Rexanne Ennis is 1042 Mar Walt Dr, Fort Walton Beach, FL and can be reached out via phone at 850-863-0400 and via fax at 850-863-0417.

Location: 1042 Mar Walt Dr, Fort Walton Beach, FL, 32547-1267
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1700961141
Provider Name
Tara Rexanne Ennis
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
1042 Mar Walt Dr, Fort Walton Beach, FL, 32547-1267
Phone Number
850-863-0400
Fax Number
850-863-0417
Provider Enumeration Date
10/26/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
120202 05 AL
102I028400 01 M'CARE PROVIDER #
institution
Provider Business Practice Location Address Details
Address
1042 Mar Walt Dr
City
Fort Walton Beach
State
Florida
Zip
32547-6645
Phone Number
850-863-0400
Fax Number
850-863-0417
person
Provider Business Mailing Address Details
Address
1042 Mar Walt Dr
City
Fort Walton Beach
State
Florida
Zip
32547-6645
Phone Number
850-863-0400
Fax Number
850-863-0417
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
ME121048 (Florida)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
-
Taxonomy
208600000X
License No.
28214 (Alabama)
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
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