=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487537627
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TALON WEIGHT LOSS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/28/2025
-----------------------------------------------------
Last Update Date | 07/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6224 LAFAYETTE ST
-----------------------------------------------------
City | NEW PORT RICHEY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34652-2626
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-314-3975
-----------------------------------------------------
Fax | 727-777-6884
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11718 ENTERPRISE DR
-----------------------------------------------------
City | PORT RICHEY
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34668-1024
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-600-3923
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COO
-----------------------------------------------------
Name | JENNIFER HEWITT
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 727-600-3923
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------