Provider Demographics
NPI:1124351564
Name:HYGEA ESSENTIALS, PLLC
Entity type:Organization
Organization Name:HYGEA ESSENTIALS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARYLE
Authorized Official - Middle Name:LYNE
Authorized Official - Last Name:CLYATT
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP, FNP-BC
Authorized Official - Phone:239-939-1999
Mailing Address - Street 1:7890 SUMMERLIN LAKES DR
Mailing Address - Street 2:#3
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1851
Mailing Address - Country:US
Mailing Address - Phone:239-939-1999
Mailing Address - Fax:239-939-4935
Practice Address - Street 1:7890 SUMMERLIN LAKES DR
Practice Address - Street 2:#3
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-1851
Practice Address - Country:US
Practice Address - Phone:239-939-1999
Practice Address - Fax:239-939-4935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-17
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3285992363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001329200Medicaid
FL001329200Medicaid