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General NPI Number Information
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NPI Number | 1649813536
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Entity Type | Organization
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Legal Business Name | FAITH & HOPE LLC
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Dates
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Enumeration Date | 10/23/2019
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 1647 SUN CITY CENTER PLZ STE 201
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City | SUN CITY CENTER
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State | FL
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Zip | 33573-5334
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Country | US
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Telephone | 813-820-2909
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Fax |
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Provider Business Mailing Address
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Address Line | 1647 SUN CITY CENTER PLZ STE 201
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City | SUN CITY CENTER
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State | FL
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Zip | 33573-5334
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Country | US
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Telephone | 813-820-2909
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JACQUELINE USTACHE
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Credential | APRN
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Telephone | 813-820-2909
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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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