Healthcare Provider Details

I. General information

NPI: 1205744463
Provider Name (Legal Business Name): CARDIOWELL ADULT AND GERIATRIC HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 PATLIN CIR N
LARGO FL
33770-3010
US

IV. Provider business mailing address

1710 PATLIN CIR N
LARGO FL
33770-3010
US

V. Phone/Fax

Practice location:
  • Phone: 727-222-3079
  • Fax:
Mailing address:
  • Phone: 727-222-3079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HEATHER MARIE DAWSON
Title or Position: NURSE PRACTITIONER
Credential: APRN
Phone: 727-222-3079