MEDICARE: STEVEN A. TYREE MD

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	207Q00000X	Family Medicine Physician	ME104907	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477554822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN A. TYREE MD

Provider Business Mailing Address
First Line	:	1600 LAKELAND HILLS BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-3019
Country	:	US
Telephone Number	:	863-680-7000
Fax Number	:	866-264-2519

Provider Business Practice Location Address
First Line	:	2300 E. COUNTY ROAD 540A
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33813-3825
Country	:	US
Telephone Number	:	863-680-7000
Fax Number	:	866-264-2519

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	11/27/2023

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Directions to “ STEVEN A. TYREE MD” Practice Location

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