Healthcare Provider Details

I. General information

NPI: 1316630536
Provider Name (Legal Business Name): HEMBREE WADE POINDEXTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2023
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7010 15TH ST N
ST PETERSBURG FL
33702-5738
US

IV. Provider business mailing address

421 KNOTTS CT
LEXINGTON SC
29073-7293
US

V. Phone/Fax

Practice location:
  • Phone: 727-200-4045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: