Organization

Tyrone Manor

Point of Service in Saint Petersburg, FL(View on Map)

Legal Business Name

Tyrone Manor

NPI Number

1073721718

NPI Type

Organization

Enumeration Date

05/18/2007

Specialties

(Taxonomies)

Code

305S00000X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

7309

Contact
Information

Purpose

Mailing
Location

Address

2192 74TH ST N
2192 74TH ST N

City

Saint Petersburg
Saint Petersburg

State

FL
FL

Postal Code

33710-4635
33710-4635

Country

US
US

Telephone Number

(727) 434-2115
(727) 434-2115

Authorized Official

Name

Wesley Wing

Title or Position

ADMINISTRATOR

Telephone Number

(727) 434-2115

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/22/2020

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