Provider Demographics
NPI:1447391644
Name:LYDA D TYMIAK MD PA
Entity Type:Organization
Organization Name:LYDA D TYMIAK MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:TYMIAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-785-4419
Mailing Address - Street 1:2650 TAMPA RD
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3144
Mailing Address - Country:US
Mailing Address - Phone:727-785-4419
Mailing Address - Fax:727-789-3351
Practice Address - Street 1:2650 TAMPA RD
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3144
Practice Address - Country:US
Practice Address - Phone:727-785-4419
Practice Address - Fax:727-789-3351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty