Rasheda Juandrell Tyson
Prosthetist
2702 Massachusetts Ave Apt 185
Pensacola
, Florida 32505-3475
Rasheda Juandrell Tyson
Prosthetist
2702 Massachusetts Ave Apt 185
Pensacola
, Florida 32505-3475
(850) 382-7803
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About
Features
Specialties
- Prosthetist
Languages spoken
- English
Location
First Address
- Rasheda Juandrell Tyson
- 2702 Massachusetts Ave Apt 185
- Pensacola, FL
- Zip : 32505-3475
- Phone : (850) 382-7803
Second Address
- Rasheda Juandrell Tyson
- 2702 Massachusetts Ave Apt 185
- Pensacola, FL
- Zip : 32505-3475
- Phone : (850) 382-7803
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Is Rasheda Juandrell Tyson a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 224P00000X | Prosthetist | CL1275593 | FL |
National Provider Identifier
| NPI | 1093337958 |
|---|---|
| Provider Name | Rasheda Juandrell Tyson |
| First Address | Pensacola, FL 32505-3475 |
| Second Address | Pensacola, FL 32505-3475 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/05/2020 |
| Last Update Date | 14/05/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0827 | NONE (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.