Individual
TYLER LYALL HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
929 NORTH US HWY 441/27, SUITE 601, LADY LAKE, FL 32159
(352) 633-0473
(866) 208-9972
Mailing address
929 N US HWY 441 STE 601, LADY LAKE, FL 32159-3003
(352) 633-0473
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9119365
FL
Other
Enumeration date
10/18/2024
Last updated
03/28/2025
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