Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 22468 | NE |
N | 207X00000X | Orthopaedic Surgeon | ME123773 | FL |
NPI | 1033149067 |
---|---|
Provider Name | Patrick Henry Tyrance JR. |
First Address | Wilton Manors, FL 33311-1612 |
Second Address | Wilton Manors, FL 33311-1612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 18/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
016556600 | (05) | FL |
02671 | BCBS OF NEBRASKA (01) | NE |
07168 | BCBS (01) | NE |
0890216 | CIGNA (01) | FL |
099588015 | MEDICARE (01) | |
10025562100 | (05) | NE |
141846792 | UNITED HEALTH CARE (01) | FL |
2586594 | (05) | IA |
H80757 | (02) | NE |
HQFJR | BCBS (01) | FL |
P00341847 | RAILROAD MEDICARE (01) | NE |