Healthcare Provider Details

I. General information

NPI: 1861200644
Provider Name (Legal Business Name): STMEDICALNURSINGSERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/25/2024
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 N MLK JR AVE APT 1804
CLEARWATER FL
33755-3336
US

IV. Provider business mailing address

1001 N MLK JR AVE APT 1804
CLEARWATER FL
33755-3336
US

V. Phone/Fax

Practice location:
  • Phone: 727-819-6281
  • Fax:
Mailing address:
  • Phone: 727-819-6281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: SABRINA MICHELLE TISDALE
Title or Position: HEALTHCARE PROVIDER
Credential:
Phone: 727-819-6281