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General NPI Number Information
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NPI Number | 1356607857
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Entity Type | Individual
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Provider Name | TYLER DEAN SEXTON M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/09/2012
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 1698 W HIBISCUS BLVD
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City | MELBOURNE
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State | FL
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Zip | 32901-2639
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Country | US
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Telephone | 727-515-7379
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Fax |
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Provider Business Mailing Address
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Address Line | 612 CORPORATE WAY STE 2M
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City | VALLEY COTTAGE
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State | NY
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Zip | 10989-2027
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Country | US
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Telephone | 877-258-6331
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Fax | 718-414-1651
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME120700
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD.34368
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 23923
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number | 23923
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number | MD.34368
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License Number State | AL
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Taxonomy #6
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number | ME120700
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License Number State | FL
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