Individual
MR. WILLIAM G TYE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 NW SAINT JAMES DR, SUITE C, PORT ST LUCIE, FL 34983-1291
(772) 249-9450
(772) 249-0701
Mailing address
201 NW SAINT JAMES DR, SUITE C, PORT ST LUCIE, FL 34983-1291
(772) 249-9450
(772) 249-0701
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP1293
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0648
BLUECROSS BLUESHIELD
FL
Enumeration date
12/28/2006
Last updated
09/02/2016
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