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	283Q00000X	Psychiatric Hospital

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619645785
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	:	813-239-8069
Fax Number	:	813-231-7324

Provider Business Practice Location Address
First Line	:	2212 E HENRY AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4433
Country	:	US
Telephone Number	:	813-239-8069
Fax Number	:	813-231-7324

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

Provider Enumeration Date	:	09/02/2021
Last Update Date	:	01/14/2026

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Directions to “IBIS HEALTHCARE INC ” Practice Location

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