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General NPI Number Information
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NPI Number | 1598905747
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Entity Type | Organization
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Legal Business Name | MCZELL HEALTH CARE
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Dates
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Enumeration Date | 03/01/2009
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Last Update Date | 03/01/2009
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Provider Practice Location Address
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Address Line | 2301 E COLBY LN
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City | TAMPA
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State | FL
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Zip | 33612-7157
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Country | US
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Telephone | 813-377-5422
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Fax |
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Provider Business Mailing Address
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Address Line | 13071 119TH ST
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City | LARGO
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State | FL
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Zip | 33778-1411
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Country | US
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Telephone | 813-377-5422
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MELISSA LONETTE MCZELL
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Credential | RN
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Telephone | 813-377-5422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | AL11405
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License Number State | FL
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