Individual
IYANNA TIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1045 55TH AVE S, ST PETERSBURG, FL 33705-5013
(727) 510-1171
Mailing address
1045 55TH AVE S, ST PETERSBURG, FL 33705-5013
(727) 510-1171
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9549448
FL
Other
Enumeration date
06/03/2025
Last updated
06/03/2025
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