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General NPI Number Information
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NPI Number | 1225980006
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Entity Type | Organization
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Legal Business Name | IBIS HEALTHCARE INC
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 348 W HIGHLAND DR
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City | LAKELAND
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State | FL
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Zip | 33813-1543
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Country | US
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Telephone | 863-608-7778
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Fax |
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Provider Business Mailing Address
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Address Line | 5707 N 22ND ST
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City | TAMPA
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State | FL
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Zip | 33610-4350
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROAYA TYSON
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Credential |
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Telephone | 813-239-8088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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