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General NPI Number Information
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NPI Number | 1003674292
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Entity Type | Organization
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Legal Business Name | MAGNANIMITY RESOURCE HEALTH
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Dates
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Enumeration Date | 03/12/2024
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 5401 W KENNEDY BLVD STE 100
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City | TAMPA
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State | FL
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Zip | 33609-2457
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Country | US
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Telephone | 813-317-1787
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Fax | 813-762-1471
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Provider Business Mailing Address
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Address Line | 5401 W KENNEDY BLVD STE 100
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City | TAMPA
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State | FL
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Zip | 33609-2457
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Country | US
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Telephone | 813-317-1787
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | MRS. ERICA CLIPPS
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Credential | APRN, FNP-BC
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Telephone | 813-317-1787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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