Tyshan Nishel Austin, PA
Physician Assistant, Medical in Hollywood, FL. Individual provider (NPI-1).
NPI number1760617708
StatusActive
Last updated in NPPESJul 11, 2023
Details
- NPI
- 1760617708
- Entity type
- Individual (NPI-1)
- Name
- Ms. Tyshan Nishel Austin
- Credential
- PA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 20, 2009
- Certification date
- Jul 11, 2023
- Last updated
- Jul 11, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | PA 9104993 | FL | Yes |
Practice location
5647 Hollywood BlvdHollywood, FL 33021-6325
Phone 954-276-1616 · Fax 954-276-0186
Mailing address
2900 Corporate WayDoor D
Miramar, FL 33025-3925
Phone 954-276-5685 · Fax 954-985-7074
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