Healthcare Provider Details

I. General information

NPI: 1578427316
Provider Name (Legal Business Name): HEART BRIDGE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5131 PALM PARK CT UNIT 202
TAMPA FL
33610-4054
US

IV. Provider business mailing address

5131 PALM PARK CT UNIT 202
TAMPA FL
33610-4054
US

V. Phone/Fax

Practice location:
  • Phone: 813-523-5392
  • Fax:
Mailing address:
  • Phone: 813-523-5392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY STATEN
Title or Position: CEO/NURSE
Credential:
Phone: 813-523-5392