Healthcare Provider Details

I. General information

NPI: 1851248181
Provider Name (Legal Business Name): TYRONIA L BELL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 S GARDEN LAKE DR
SAINT AUGUSTINE FL
32086-5236
US

IV. Provider business mailing address

920 S GARDEN LAKE DR
SAINT AUGUSTINE FL
32086-5236
US

V. Phone/Fax

Practice location:
  • Phone: 386-442-5054
  • Fax:
Mailing address:
  • Phone: 386-442-5054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11046089
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: