Provider Demographics
NPI:1417775529
Name:CALYX LLC
Entity type:Organization
Organization Name:CALYX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:KRYDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-237-1403
Mailing Address - Street 1:1533 TAWNYBERRY CT
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5351
Mailing Address - Country:US
Mailing Address - Phone:727-237-1403
Mailing Address - Fax:
Practice Address - Street 1:1533 TAWNYBERRY CT
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-5351
Practice Address - Country:US
Practice Address - Phone:727-237-1403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty