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General NPI Number Information
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NPI Number | 1134330228
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Entity Type | Individual
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Provider Name | TYRONE P. ROBERTS LMT
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Gender | Male
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 12/23/2011
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Provider Practice Location Address
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Address Line | 411 S. GARDEN AVE. #3
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City | CLEARWATER
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State | FL
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Zip | 33756-5529
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Country | US
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Telephone | 813-802-5589
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Fax | 727-953-8995
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Provider Business Mailing Address
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Address Line | 411 S. GARDEN AVE. #3
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City | CLEARWATER
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State | FL
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Zip | 33756-5529
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Country | US
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Telephone | 813-802-5589
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Fax | 727-953-8995
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA 47862
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License Number State | FL
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