Provider Demographics
NPI:1780134577
Name:VYAS, HEMANG (PT)
Entity type:Individual
Prefix:
First Name:HEMANG
Middle Name:
Last Name:VYAS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 TERRA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-6632
Mailing Address - Country:US
Mailing Address - Phone:813-601-4616
Mailing Address - Fax:
Practice Address - Street 1:9780 N 56TH ST
Practice Address - Street 2:SUITE-C
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-5508
Practice Address - Country:US
Practice Address - Phone:813-601-4616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT29173225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist