Tyler Jon Long, DO | |
3614 Kiessel Rd, The Villages, FL 32163-2910 | |
(352) 914-3451 | |
Not Available |
Full Name | Tyler Jon Long |
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Gender | Male |
Speciality | Dermatology |
Location | 3614 Kiessel Rd, The Villages, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851954242 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207N00000X | Dermatology | 25MB12236700 (New Jersey) | Secondary |
208D00000X | General Practice | 0116034370 (Virginia) | Secondary |
207N00000X | Dermatology | 21531 (Florida) | Primary |
Entity Name | Signify Health Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1689158487 PECOS PAC ID: 3274895263 Enrollment ID: O20210226002383 |
Mailing Address | Practice Location Address |
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Tyler Jon Long, DO 3614 Kiessel Rd, The Villages, FL 32163-2910 Ph: (352) 914-3451 | Tyler Jon Long, DO 3614 Kiessel Rd, The Villages, FL 32163-2910 Ph: (352) 914-3451 |
Charles F Knapp Iii, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2783 Brownwood Blvd, The Villages, FL 32163 Phone: 352-834-7546 | |
Dr. Brandon Max Markus, D.O. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 2783 Brownwood Blvd, The Villages, FL 32163 Phone: 352-834-7546 Fax: 352-383-1951 | |
David John Casper, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 8620a E County Road 466, The Villages, FL 32162 Phone: 352-399-7295 Fax: 352-399-7294 | |
Dr. Tarek S Shaath, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1040 Lake Sumter Lndg, The Villages, FL 32162 Phone: 352-218-3211 Fax: 877-699-3709 | |
Trisha Khanna, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 1580 Santa Barbara Blvd, The Villages, FL 32159 Phone: 352-516-3972 | |
Thi Thien Tran, DO Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1950 Laurel Manor Dr, Bldg 220 Ste 224, The Villages, FL 32162 Phone: 352-751-6565 Fax: 352-205-7777 | |
Dr. Joanna Grace Bolton, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1050 Old Camp Rd, The Villages, FL 32162 Phone: 352-399-7295 Fax: 352-399-7294 |