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NPI Code Detail

MEDICARE: WYKINDA TUMESA FANTROY FNP-C

MEDICARE:   WYKINDA TUMESA FANTROY  FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianF03240335FL

General Provider Information

NPI Number : 1295585016
Entity Type Code : Individual
Provider Name (Legal Business Name) : WYKINDA TUMESA FANTROY FNP-C
Provider Business Mailing Address
First Line : 3607 N GARRISON ST
Second Line :
City : TAMPA
State : FL
Zip : 33619-1543
Country : US
Telephone Number : 813-789-2262
Fax Number :
Provider Business Practice Location Address
First Line : 3607 N GARRISON ST
Second Line :
City : TAMPA
State : FL
Zip : 33619-1543
Country : US
Telephone Number : 813-789-2262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2024
Last Update Date : 03/25/2024

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Directions to “ WYKINDA TUMESA FANTROY FNP-C” Practice Location

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