Healthcare Provider Details

I. General information

NPI: 1295690634
Provider Name (Legal Business Name): TRANQUILITY MENTAL HEALTH PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S RIVERSIDE DR STE 151
INDIALANTIC FL
32903-4321
US

IV. Provider business mailing address

105 S RIVERSIDE DR STE 151
INDIALANTIC FL
32903-4321
US

V. Phone/Fax

Practice location:
  • Phone: 321-327-4606
  • Fax: 321-327-3278
Mailing address:
  • Phone: 321-327-4606
  • Fax: 321-327-3278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: RYAN C MYERS
Title or Position: CEO
Credential: APRN
Phone: 865-246-8508