NPI 1073721718

Tyrone Manor

Organisation Point of Service Saint Petersburg, FL

Practice location

Address: 2192 74th St N, Saint Petersburg, FL 33710-4635
Phone: (727) 434-2115

Authorised official

Name: Wesley Charles Wing
Title: Administrator
Phone: (727) 434-2115

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X Licence 7309 (FL)

Other Point of Service providers in Florida →

Registry record

NPI: 1073721718
Entity type: Organization
NPI issued: 18 May 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.