Healthcare Provider Details
I. General information
NPI: 1174250336
Provider Name (Legal Business Name): NP CARE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/06/2022
Last Update Date: 06/07/2025
Certification Date: 06/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2519 N MCMULLEN BOOTH RD # 510-111
CLEARWATER FL
33761-4173
US
IV. Provider business mailing address
2519 N MCMULLEN BOOTH RD # 510-111
CLEARWATER FL
33761-4173
US
V. Phone/Fax
- Phone: 863-333-8376
- Fax: 863-617-9876
- Phone: 863-333-8376
- Fax: 863-617-9876
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMY
BOCKELKAMP
Title or Position: APRN-C
Credential: DNP
Phone: 863-333-8376