Organization
TYRONE MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY CHARLES WING (ADMINISTRATOR)
(727) 434-2115
Entity
Organization
Contact information
Practice address
2192 74TH ST N, SAINT PETERSBURG, FL 33710-4635
(727) 434-2115
Mailing address
2192 74TH ST N, SAINT PETERSBURG, FL 33710-4635
(727) 434-2115
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
7309
FL
Other
Enumeration date
05/18/2007
Last updated
08/22/2020
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