Healthcare Provider Details

I. General information

NPI: 1972134401
Provider Name (Legal Business Name): DRAGONFLIES NEW BEGINNINGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2020
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 N MACDILL AVE STE 116
TAMPA FL
33607-2284
US

IV. Provider business mailing address

PO BOX 10192
TAMPA FL
33679-0192
US

V. Phone/Fax

Practice location:
  • Phone: 813-563-8227
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: DENISE D MOORE
Title or Position: CLINICAL DIRECTOR
Credential: MS, LMHC
Phone: 813-956-6325