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Contact Information

TYSHAN N AUSTIN, PA
5647 HOLLYWOOD BLVD
HOLLYWOOD, FL33021-6325
 Phone: 954-276-1616
 Fax: 954-276-0186
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for TYSHAN N AUSTIN · (Female)

NPI Number 1760617708
Status Active
Credentials PA (Physician Assistant)
Entity Individual
Enumeration date 05/20/2009
Last updated 07/11/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # PA 9104993
  • FL Medicaid 013087100
Hospital affiliation(s)
  • MEMORIAL HOSPITAL WEST - (Acute Care)
    703 N FLAMINGO RD
    PEMBROKE PINES, FL 33028
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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