Healthcare Provider Details

I. General information

NPI: 1831922913
Provider Name (Legal Business Name): DEKAYLA SALICE LAWSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2024
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10225 ULMERTON RD STE 1A
LARGO FL
33771-3522
US

IV. Provider business mailing address

PO BOX 850001, DEPT 8340
ORLANDO FL
32885-0001
US

V. Phone/Fax

Practice location:
  • Phone: 727-585-7408
  • Fax: 866-980-2443
Mailing address:
  • Phone: 813-536-7277
  • Fax: 855-830-1722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11034765
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: