Individual
MS. TYSHAN NISHEL AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5647 HOLLYWOOD BLVD, HOLLYWOOD, FL 33021-6325
(954) 276-1616
(954) 276-0186
Mailing address
2900 CORPORATE WAY, DOOR D, MIRAMAR, FL 33025-3925
(954) 276-5685
(954) 985-7074
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 9104993
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013087100
—
FL
Enumeration date
05/20/2009
Last updated
07/11/2023
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