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General NPI Number Information
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NPI Number | 1144940735
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Entity Type | Organization
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Legal Business Name | ELEANOR HEALTH PROFESSIONAL FL PLLC
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Dates
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Enumeration Date | 09/01/2022
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 4014 GUNN HWY STE 160
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City | TAMPA
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State | FL
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Zip | 33618-8786
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Country | US
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Telephone | 866-402-7631
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 386
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City | PORTSMOUTH
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State | NH
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Zip | 03802-0386
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Country | US
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Telephone | 919-765-8744
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | NZGINGA HARRISON
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Credential |
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Telephone | 617-419-0858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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