Healthcare Provider Details

I. General information

NPI: 1003952813
Provider Name (Legal Business Name): KERRY SCHINELLA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 TASHA DR
CLEARWATER FL
33761-1222
US

IV. Provider business mailing address

2770 TASHA DR
CLEARWATER FL
33761-1222
US

V. Phone/Fax

Practice location:
  • Phone: 727-785-5268
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN2906972
License Number StateFL

VIII. Authorized Official

Name: KERRY SCHINELLA
Title or Position: R.N.
Credential:
Phone: 727-785-5268