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General NPI Number Information
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NPI Number | 1447010731
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Entity Type | Organization
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Legal Business Name | COLLIER AT TYRONE, LLC
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Dates
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Enumeration Date | 03/21/2024
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 1701 68TH ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-8744
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Country | US
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Telephone | 813-447-9260
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Fax |
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Provider Business Mailing Address
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Address Line | 218 E BEARSS AVE STE 333
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City | TAMPA
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State | FL
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Zip | 33613-1625
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Country | US
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Telephone | 813-447-9260
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MR. ALCIDES SEGUI SR.
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Credential |
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Telephone | 813-447-9260
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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