Provider Demographics
NPI:1306838750
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:MS
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOMOANO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:786-316-5118
Mailing Address - Street 1:10411 SW 108TH AVE
Mailing Address - Street 2:#D263
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-8142
Mailing Address - Country:US
Mailing Address - Phone:786-316-5118
Mailing Address - Fax:305-412-0933
Practice Address - Street 1:10411 SW 108TH AVE
Practice Address - Street 2:#D263
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-8142
Practice Address - Country:US
Practice Address - Phone:786-316-5118
Practice Address - Fax:305-412-0933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL568816-4225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU4538ZMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER