Provider Demographics
NPI:1184448987
Name:TRESSES MEDICAL HEALTH AND CARE, LLC
Entity type:Organization
Organization Name:TRESSES MEDICAL HEALTH AND CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAQUITSHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TYSON-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-485-2242
Mailing Address - Street 1:2047 SW DANFORTH CIR
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-7704
Mailing Address - Country:US
Mailing Address - Phone:772-485-2242
Mailing Address - Fax:
Practice Address - Street 1:2047 SW DANFORTH CIR
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-7704
Practice Address - Country:US
Practice Address - Phone:772-485-2242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-09
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier