Healthcare Provider Details

I. General information

NPI: 1679853220
Provider Name (Legal Business Name): TAMMY LEE CALIGIURI RMHCI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2011
Last Update Date: 08/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 STARCREST DR
CLEARWATER FL
33765-3224
US

IV. Provider business mailing address

4619 CHELSEA CT
TITUSVILLE FL
32796-1440
US

V. Phone/Fax

Practice location:
  • Phone: 727-461-2990
  • Fax:
Mailing address:
  • Phone: 321-268-3372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH 8144
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: