MEDICARE: IBIS HEALTHCARE INC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1225980006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IBIS HEALTHCARE INC

Provider Business Mailing Address
First Line	:	5707 N 22ND ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4350
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	348 W HIGHLAND DR
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33813-1543
Country	:	US
Telephone Number	:	863-608-7778
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ROAYA TYSON
Credential	:
Telephone Number	:	813-239-8088

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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Directions to “IBIS HEALTHCARE INC ” Practice Location

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