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General NPI Number Information
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NPI Number | 1114310927
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Entity Type | Organization
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Legal Business Name | TYLER & JACOB CONSULTING GROUP, LLC
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Dates
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Enumeration Date | 03/18/2015
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Last Update Date | 03/23/2015
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Provider Practice Location Address
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Address Line | 18501 PINES BLVD SUITE 300
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-1414
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Country | US
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Telephone | 866-462-7202
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Fax | 866-656-2662
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Provider Business Mailing Address
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Address Line | 18501 PINES BLVD SUITE 300
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City | PEMBROKE PINES
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State | FL
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Zip | 33029-1414
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Country | US
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Telephone | 866-462-7202
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Fax | 866-656-2662
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. JESSICA WILLIAMS
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Credential | RN
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Telephone | 866-462-7202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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