Healthcare Provider Details

I. General information

NPI: 1285597278
Provider Name (Legal Business Name): MEVOLI & HANCOCK FAMILY DENTISTRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5415 PARK ST N STE A
SAINT PETERSBURG FL
33709-1028
US

IV. Provider business mailing address

5415 PARK ST N STE A
SAINT PETERSBURG FL
33709-1028
US

V. Phone/Fax

Practice location:
  • Phone: 727-541-5606
  • Fax: 727-545-9723
Mailing address:
  • Phone: 727-541-5606
  • Fax: 727-545-9723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. WADE HANCOCK
Title or Position: OWNER/ DENTIST
Credential: DMD
Phone: 727-541-5606