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Individual

VINCENT TYSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5333 N DIXIE HWY STE 110, OAKLAND PARK, FL 33334-3453
(954) 772-8554
Mailing address
441 SE 3RD CT, DEERFIELD BEACH, FL 33441-4727
(516) 661-1805

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AP61299531
WA
363LP2300X
Primary Care Nurse Practitioner
11005143
FL
363LP2300X
Primary Care Nurse Practitioner
SPO13376
PA

Other

Enumeration date
11/06/2013
Last updated
02/06/2024
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