Healthcare Provider Details

I. General information

NPI: 1801699707
Provider Name (Legal Business Name): TYNER HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2025
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 S CONGRESS AVE
ATLANTIS FL
33462-1149
US

IV. Provider business mailing address

1202 SW 17TH ST STE 201
OCALA FL
34471-1283
US

V. Phone/Fax

Practice location:
  • Phone: 561-965-7300
  • Fax:
Mailing address:
  • Phone: 352-237-7646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: JESSIE BENTON
Title or Position: ADMINISTRATOR
Credential:
Phone: 352-237-7646