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NPI Code Detail

MEDICARE: TYDERIA METZ

MEDICARE: TYDERIA METZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1144959081
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYDERIA METZ
Provider Business Mailing Address
First Line : 1500 S DOUGLAS RD STE 230
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4108
Country : US
Telephone Number : 844-244-1818
Fax Number : 888-512-0733
Provider Business Practice Location Address
First Line : 1822 SPRING GARDEN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19130-4122
Country : US
Telephone Number : 844-854-1818
Fax Number : 888-512-0733
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2022
Last Update Date : 06/07/2022

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Directions to “ TYDERIA METZ ” Practice Location

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