MEDICARE: GERARD TYLOR TEAMER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WE0003X	Emergency Registered Nurse	RN9621961	FL

General Provider Information

NPI Number	:	1124973581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERARD TYLOR TEAMER

Provider Business Mailing Address
First Line	:	562 ROBIN HILL CIR
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33510-3319
Country	:	US
Telephone Number	:	813-894-8655
Fax Number	:

Provider Business Practice Location Address
First Line	:	6150 S FLORIDA AVE
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33813-3306
Country	:	US
Telephone Number	:	863-687-1100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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