MEDICARE: IBIS HEALTHCARE INC

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	251B00000X	Case Management Agency
3	251S00000X	Community/Behavioral Health Agency

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1346224011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IBIS HEALTHCARE INC

Provider Business Mailing Address
First Line	:	5707 N 22ND ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4350
Country	:	US
Telephone Number	:	813-239-8069
Fax Number	:	813-231-7324

Provider Business Practice Location Address
First Line	:	5707 N. 22ND STREET
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4350
Country	:	US
Telephone Number	:	813-239-8069
Fax Number	:	813-231-7324

Authorized Official
Title or Position	:	CEO
Name	:	ROAYA TYSON
Credential	:
Telephone Number	:	813-239-8088

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	01/14/2026

5707 N 22ND STREET
TAMPA, FL
33610-4350

Practice Phone: 813-239-8069
Practice Fax: 813-231-7324