Individual provider Active NPI

Bernadette Lee Tyler

  • Speech-Language Pathologist
  • Gainesville, FL
National Provider Identifier
1629435573
Registry record updated Jan 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ7465 Issued in FL
Practice address
250 NW 76TH Dr
Gainesville, FL 32607-6668
Phone
(352) 505-6363
NPI assigned
Jan 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SZ7465 FL Primary

Addresses

Primary practice location

250 NW 76TH Dr
Gainesville, FL 32607-6668

Mailing address

2352 NW 45TH LN
Gainesville, FL 32605-1252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SZ7465FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1453507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453507200000",
    "number": "1629435573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2352 NW 45TH LN",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326051252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 NW 76TH DR",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326076668",
            "telephone_number": "352-505-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYLER",
        "first_name": "BERNADETTE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-23",
        "last_updated": "2016-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ7465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.