MEDICARE: PATRICIA ELLEN TIRONE LCSW

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
1	1041C0700X	Clinical Social Worker	SW 10864	FL
2	1041C0700X	Clinical Social Worker	R025511-1	NY

General Provider Information

NPI Number	:	1619083649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA ELLEN TIRONE LCSW

Provider Business Mailing Address
First Line	:	27499 RIVERVIEW CENTER BLVD STE 451
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-4344
Country	:	US
Telephone Number	:	239-913-6552
Fax Number	:	239-913-6555

Provider Business Practice Location Address
First Line	:	27499 RIVERVIEW CENTER BLVD STE 451
Second Line	:
City	:	BONITA SPRINGS
State	:	FL
Zip	:	34134-4344
Country	:	US
Telephone Number	:	239-913-6552
Fax Number	:	239-913-6555

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	12/14/2024

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