Healthcare Provider Details

I. General information

NPI: 1902733082
Provider Name (Legal Business Name): AVA MCLAMB
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 5TH AVE N
ST PETERSBURG FL
33705-1400
US

IV. Provider business mailing address

1201 5TH AVE N
ST PETERSBURG FL
33705-1400
US

V. Phone/Fax

Practice location:
  • Phone: 727-521-0994
  • Fax:
Mailing address:
  • Phone: 727-521-0994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11048589
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN03282025
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: