Healthcare Provider Details

I. General information

NPI: 1497113534
Provider Name (Legal Business Name): CLAUDIA LEGASPI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2016
Last Update Date: 02/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 6TH ST S
ST PETERSBURG FL
33701-4814
US

IV. Provider business mailing address

7013 50TH AVE N
ST PETERSBURG FL
33709-2809
US

V. Phone/Fax

Practice location:
  • Phone: 727-823-1234
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN9175136
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: