Provider Demographics
NPI:1275588535
Name:TYS HEALTH CARE INC
Entity Type:Organization
Organization Name:TYS HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMOANO
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:305-274-9882
Mailing Address - Street 1:12915 SW 132ND ST
Mailing Address - Street 2:#4-B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6294
Mailing Address - Country:US
Mailing Address - Phone:305-259-4408
Mailing Address - Fax:305-259-4409
Practice Address - Street 1:12915 SW 132ND ST
Practice Address - Street 2:#4-B
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6294
Practice Address - Country:US
Practice Address - Phone:305-259-4408
Practice Address - Fax:305-259-4409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT20555225100000X
FLOT10808225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7465Medicare ID - Type UnspecifiedMEDICARE PROVIDER#