Healthcare Provider Details

I. General information

NPI: 1952223521
Provider Name (Legal Business Name): DORIS MARICEL CARANDANG LAGAT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 W BAY DR STE 605
LARGO FL
33770-3268
US

IV. Provider business mailing address

2107 OAK GROVE DR
CLEARWATER FL
33764-3732
US

V. Phone/Fax

Practice location:
  • Phone: 727-489-3305
  • Fax: 727-499-9559
Mailing address:
  • Phone: 727-489-3305
  • Fax: 727-499-9559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11049567
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: