Provider Demographics
NPI:1750391371
Name:THYS, SERGE (MD)
Entity type:Individual
Prefix:MR
First Name:SERGE
Middle Name:
Last Name:THYS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 CORPORATE WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2032
Mailing Address - Country:US
Mailing Address - Phone:561-863-7800
Mailing Address - Fax:561-840-0747
Practice Address - Street 1:5730 CORPORATE WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2032
Practice Address - Country:US
Practice Address - Phone:561-863-7800
Practice Address - Fax:561-840-0747
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00597942084P0800X
FLME-00597942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376590300Medicaid
FL26466Medicare ID - Type Unspecified
FL376590300Medicaid