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NPI 1417878471

NPI 1417878471 : SHO LOVE PSYCHIATRY & HEALTH : TAMPA, FL

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General NPI Number Information
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    NPI Number           |    1417878471
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    Entity Type          |    Organization 
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    Legal Business Name  |    SHO LOVE PSYCHIATRY & HEALTH 
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Dates
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    Enumeration Date     |    07/23/2026
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    Last Update Date     |    07/23/2026
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Provider Practice Location Address
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    Address Line         |    15257 AMBERLY DR STE 608 
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    City                 |    TAMPA
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    State                |    FL
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    Zip                  |    33647-2155
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    Country              |    US
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    Telephone            |    904-701-4822
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    15257 AMBERLY DR STE 608 
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    City                 |    TAMPA
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    State                |    FL
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    Zip                  |    33647-2155
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    Country              |    US
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    Telephone            |    904-701-4822
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     SHIDELLE  WATSON 
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    Credential           |    APRN, PMHNP-BC
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    Telephone            |    904-701-4822
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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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