Staley, Tyler Jay

Staley, Tyler Jay is an individual health care provider with primary practice located at 350 N Clyde Morris Blvd , Daytona Beach FL 32114-2733. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Staley, Tyler Jay can be contacted via phone (386) 238-3290.

Contact Information

Primary practice address
350 N Clyde Morris Blvd Daytona Beach FL 32114-2733
Phone: (386) 238-3290
Fax: (386) 238-3278
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 44335 Kentucky
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X 112139 Florida

Profile Details

NPI number 1013189877
LBN Legal business name Staley, Tyler Jay
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 1st, 2008
Last updated Jul 11th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013189877 NPPES
Florida Other 1013189877 TRICARE
Florida MEDICAID 007276600 TRICARE
Florida Other 14MV1 TRICARE

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