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General NPI Number Information
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NPI Number | 1396552725
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Entity Type | Organization
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Legal Business Name | CENTERMARK HEALTH LLC
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Dates
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Enumeration Date | 12/18/2024
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 8270 WOODLAND CENTER BLVD
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City | TAMPA
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State | FL
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Zip | 33614-2401
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Country | US
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Telephone | 888-813-1323
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Fax | 813-863-1992
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Provider Business Mailing Address
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Address Line | 27251 WESLEY CHAPEL BLVD STE 1037
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-4285
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Country | US
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Telephone | 888-813-1323
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Fax | 813-863-1992
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Authorized Official
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Title or Position | OWNER
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Name | LATRICE MARKISON
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Credential | PMHNP
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Telephone | 813-416-9245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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