Healthcare Provider Details

I. General information

NPI: 1962225821
Provider Name (Legal Business Name): MEANINGFUL CONCIERGE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2927 PEARSON JAMES PL
LUTZ FL
33559-6996
US

IV. Provider business mailing address

10829 BREAKING ROCKS DR
TAMPA FL
33647-3585
US

V. Phone/Fax

Practice location:
  • Phone: 813-991-4744
  • Fax: 813-907-5067
Mailing address:
  • Phone: 404-370-2158
  • Fax: 813-907-5067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ERICA EVANS
Title or Position: OWNER
Credential:
Phone: 404-370-2158