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General NPI Number Information
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NPI Number | 1316712771
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Entity Type | Organization
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Legal Business Name | STRATEGIC HEALTHCARE
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Dates
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Enumeration Date | 11/16/2023
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 134 49TH ST S
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City | SAINT PETERSBURG
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State | FL
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Zip | 33707-1924
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Country | US
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Telephone | 727-558-2417
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Fax |
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Provider Business Mailing Address
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Address Line | 4411 CORTEZ WAY S
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City | SAINT PETERSBURG
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State | FL
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Zip | 33712-4026
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Country | US
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Telephone | 727-558-2417
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTAL GREEN
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Credential | APRN
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Telephone | 727-558-2417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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