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General NPI Number Information
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NPI Number | 1780335646
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Entity Type | Organization
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Legal Business Name | SHUSHRUT HEALTH LLC
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Dates
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Enumeration Date | 01/12/2022
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 6222 AVIGNON CT # 202
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City | TAMPA
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State | FL
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Zip | 33647-5103
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Country | US
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Telephone | 918-513-1767
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Fax |
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Provider Business Mailing Address
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Address Line | 6222 AVIGNON CT # 202
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City | TAMPA
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State | FL
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Zip | 33647-5103
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Country | US
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Telephone | 918-513-1767
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DENISSE CASTELLANOS
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Credential | CSA
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Telephone | 918-513-1767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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