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General NPI Number Information
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NPI Number | 1265090385
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Entity Type | Organization
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Legal Business Name | FAMILY NP TELEMEDICINE
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Dates
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Enumeration Date | 06/04/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 6912 CAUSEWAY BLVD
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City | TAMPA
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State | FL
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Zip | 33619-6360
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Country | US
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Telephone | 813-766-7646
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Fax | 813-354-3621
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Provider Business Mailing Address
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Address Line | 6912 CAUSEWAY BLVD
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City | TAMPA
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State | FL
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Zip | 33619-6360
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Country | US
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Telephone | 813-766-7646
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Fax | 813-354-3621
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | YESSICA SAEZ
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Credential | RHIT
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Telephone | 386-500-6397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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