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General NPI Number Information
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NPI Number | 1306450085
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Entity Type | Organization
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Legal Business Name | AZIMUTH HEALTH, LLC
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Dates
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Enumeration Date | 09/01/2020
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Last Update Date | 09/01/2020
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Provider Practice Location Address
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Address Line | 4204 W LINEBAUGH AVE
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City | TAMPA
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State | FL
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Zip | 33624-5241
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Country | US
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Telephone | 813-940-8855
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Fax |
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Provider Business Mailing Address
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Address Line | 4204 W LINEBAUGH AVE
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City | TAMPA
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State | FL
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Zip | 33624-5241
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Country | US
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Telephone | 813-940-8855
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DUELLYN PANDIS
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Credential | DNP, APRN, FNP-C
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Telephone | 813-940-8855
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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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