Healthcare Provider Details

I. General information

NPI: 1639061492
Provider Name (Legal Business Name): TYKES & TEENS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 14TH AVE
VERO BEACH FL
32960-0435
US

IV. Provider business mailing address

900 SE OCEAN BLVD STE E340
STUART FL
34994-2471
US

V. Phone/Fax

Practice location:
  • Phone: 772-220-3439
  • Fax: 772-220-3439
Mailing address:
  • Phone: 772-220-3439
  • Fax: 772-220-3484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: RACHEL SWEIKERT
Title or Position: BILLING & CREDENTIALING SPECIALIST
Credential:
Phone: 772-220-3439