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General NPI Number Information
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NPI Number | 1053804500
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Entity Type | Organization
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Legal Business Name | TRANSFIGURE TOTAL HEALTH, LLC
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Dates
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Enumeration Date | 06/10/2018
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Last Update Date | 06/10/2018
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Provider Practice Location Address
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Address Line | 303 8TH AVE E
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City | PALMETTO
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State | FL
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Zip | 34221-4262
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Country | US
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Telephone | 314-304-3380
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Fax |
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Provider Business Mailing Address
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Address Line | 303 8TH AVE E
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City | PALMETTO
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State | FL
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Zip | 34221-4262
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Country | US
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Telephone | 314-304-3380
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JANE A DAWSON
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Credential | ARNP
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Telephone | 314-304-3380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP9431230
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License Number State | FL
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