Tyler Falcao, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL 4690 Issued in FL

Practice address

4820 Deer Lake Dr W # D-9
Jacksonville, FL 32246-4500

Phone

(904) 998-9129

NPI assigned

Mar 24, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1063874402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2554 KEYLIME ST NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329054731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 DEER LAKE DR W # D-9",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322464500",
            "telephone_number": "904-998-9129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALCAO",
        "first_name": "TYLER",
        "name_prefix": "Mr.",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-24",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL 4690",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT006227",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Waddih Fakhre
• Felipe Arruda Falcao, D.D.S, M.S.
• Maria Falck
• Morgan Fall, APRN
• Kyle S Fallgatter, MD
• Laura Fallgatter
• Cindy Marie Fallon

• Athletic Trainer in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.