Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tahirah A Tyrell, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1669642237

Tahirah A Tyrell, MD is a Family Practice in Orange Park, Florida. Qualified in 2007, 19 years ago. Practices with Conviva Medical Center Management, LLC, a 562-clinician group and accepts Medicare assignment. Licensed in Florida and New York.

Years since qualifying
19
Licensed in
FL, NY
In the registry since
2008
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

20 Blanding Blvd
Orange Park, FL 32073-2235
Phone: (904) 773-8977
Fax: (904) 773-8974
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence ME115083 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence ME115083 (FL)
Family Medicine Physician Taxonomy 207Q00000X · Licence 269460 (NY)

Record details

NPI number1669642237
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 10, 2008
Last updated in NPPESFebruary 17, 2026
Certification dateFebruary 17, 2026
Mailing address6101 Blue Lagoon Dr Ste 200, Miami, FL 33126-3168

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Conviva Medical Center Management, Llc — 562 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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