Individual
DR. FARRELL C TYSON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4120 DEL PRADO BLVD S, CAPE CORAL, FL 33904-7165
(239) 542-2020
(239) 541-0175
Mailing address
4120 DEL PRADO BOULEVARD, CAPE CORAL, FL 33904
(239) 542-2020
(239) 541-1492
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME81910
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264385500
—
FL
Enumeration date
10/31/2005
Last updated
08/28/2020
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