Healthcare Provider Details
I. General information
NPI: 1831580612
Provider Name (Legal Business Name): LOVE THE GOLDEN RULE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/14/2015
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3600 CENTRAL AVE
ST PETERSBURG FL
33711-1345
US
IV. Provider business mailing address
3600 CENTRAL AVE
ST PETERSBURG FL
33711-1345
US
V. Phone/Fax
- Phone: 727-826-0700
- Fax: 727-954-6994
- Phone: 727-826-0700
- Fax: 727-954-6994
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0002X |
| Taxonomy | Hospice and Palliative Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROBERT
JENNINGS
WALLACE
Title or Position: CEO/MEDICAL DIRECTOR
Credential: MD
Phone: 727-826-0700