MEDICARE: TYRA GORDON

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1275498214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYRA GORDON

Provider Business Mailing Address
First Line	:	640 GARDEN CRESS TRL
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-4229
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1060 KIRK RD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-4956
Country	:	US
Telephone Number	:	561-304-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/22/2025

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1194274498 — LINDA ANN EVANS-CREWE BA, MPA
Practice Location Address:

4956 SABLE PINE CIR APT A2
WEST PALM BEACH, FL
33417-3112

Practice Phone: 561-603-7669
Practice Fax:

1831196369 — UNIVERSITY PLACE, INC
Practice Location Address:

1750 LINDBERG RD
WEST LAFAYETTE, IN
47906-4956

Practice Phone: 765-464-5600
Practice Fax: 765-464-5605

1164549960 — MS. FIONA MACKENZIE CALDWELL P.T.
Practice Location Address:

1284 HAVENHURST DR , APT. #107
WEST HOLLYWOOD, CA
90046-4956

Practice Phone: 323-822-0795
Practice Fax:

1225205362 — DANIEL JACKSON DDS PC
Practice Location Address:

821 WEST PINE BLVD
POPLAR BLUFF, MO
63901-4956

Practice Phone: 573-785-6434
Practice Fax: 573-785-6435

1457696874 — GAY SENIOR SERVICES LLC
Practice Location Address:

1284 HAVENHURST DR , #104
WEST HOLLYWOOD, CA
90046-4956

Practice Phone: 323-380-7952
Practice Fax:

Directions to “ TYRA GORDON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.