Healthcare Provider Details

I. General information

NPI: 1164488698
Provider Name (Legal Business Name): JOHNY TRYZMEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOHNY TRYZMEL M.D.

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 S ANDREWS AVE 4TH FLR NICU
FT LAUDERDALE FL
33316-2510
US

IV. Provider business mailing address

1600 S ANDREWS AVE 4TH FLR NICU
FT LAUDERDALE FL
33316-2510
US

V. Phone/Fax

Practice location:
  • Phone: 954-355-5870
  • Fax: 954-355-5872
Mailing address:
  • Phone: 954-355-5870
  • Fax: 954-355-5872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License NumberME85522
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberME85522
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: