Provider Demographics
NPI:1114310927
Name:TYLER & JACOB CONSULTING GROUP, LLC
Entity type:Organization
Organization Name:TYLER & JACOB CONSULTING GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:866-462-7202
Mailing Address - Street 1:18501 PINES BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-1414
Mailing Address - Country:US
Mailing Address - Phone:866-462-7202
Mailing Address - Fax:866-656-2662
Practice Address - Street 1:18501 PINES BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-1414
Practice Address - Country:US
Practice Address - Phone:866-462-7202
Practice Address - Fax:866-656-2662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-18
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care