=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912646605
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REFINE HEALTH CENTER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/01/2022
-----------------------------------------------------
Last Update Date | 02/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6338 US HIGHWAY 301 S STE 103
-----------------------------------------------------
City | RIVERVIEW
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33578-3829
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-736-5736
-----------------------------------------------------
Fax | 813-706-6580
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1211 TECH BLVD STE 110
-----------------------------------------------------
City | TAMPA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33619-7846
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-736-5736
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | KRISTA WHITE
-----------------------------------------------------
Credential | APRN
-----------------------------------------------------
Telephone | 813-956-7315
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------