Provider Demographics
NPI: | 1265473441 |
---|---|
Name: | TUYN, EUGENIA (PT, RD) |
Entity Type: | Individual |
Prefix: | MRS |
First Name: | EUGENIA |
Middle Name: | |
Last Name: | TUYN |
Suffix: | |
Gender: | F |
Credentials: | PT, RD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 9660 NW 16TH ST |
Mailing Address - Street 2: | |
Mailing Address - City: | PLANTATION |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33322-4209 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 954-473-0708 |
Mailing Address - Fax: | 954-730-2788 |
Practice Address - Street 1: | 4850 W OAKLAND PARK BLVD |
Practice Address - Street 2: | |
Practice Address - City: | LAUDERDALE LAKES |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33313-7260 |
Practice Address - Country: | US |
Practice Address - Phone: | 954-730-2789 |
Practice Address - Fax: | 954-730-2788 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-06-09 |
Last Update Date: | 2018-04-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | 8865 | 225100000X, 208100000X |
FL | 441 | 133V00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | |
No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered |