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Individual

IRENE TUNGOL WILKERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
325 NORWOOD ST, MERRITT ISLAND, FL 32953-4764
(321) 459-0530
(321) 459-0530
Mailing address
1014 WOODLAWN RD, ROCKLEDGE, FL 32955-2215
(407) 715-7845
(800) 240-2085

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL11011
FL

Other

Enumeration date
06/29/2020
Last updated
06/29/2020
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