Provider Demographics
NPI:1700517679
Name:GRANDISON, TYRONE K (DMFT, LMFT)
Entity Type:Individual
Prefix:DR
First Name:TYRONE
Middle Name:K
Last Name:GRANDISON
Suffix:
Gender:M
Credentials:DMFT, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 BISCAYNE BLVD STE 265
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-5031
Mailing Address - Country:US
Mailing Address - Phone:305-323-1252
Mailing Address - Fax:
Practice Address - Street 1:2125 BISCAYNE BLVD STE 265
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-5031
Practice Address - Country:US
Practice Address - Phone:305-323-1252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist