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General NPI Number Information
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NPI Number | 1992581904
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Entity Type | Organization
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Legal Business Name | ADVARISE HEALTH LLC
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Dates
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Enumeration Date | 09/05/2023
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Last Update Date | 09/01/2024
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Provider Practice Location Address
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Address Line | 7901 4TH ST N STE 300
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone | 404-926-6114
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 PEACHTREE ST NE STE 200
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City | ATLANTA
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State | GA
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Zip | 30309-4829
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Country | US
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Telephone | 404-926-6119
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Fax |
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Authorized Official
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Title or Position | FNP
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Name | MISS DARLY MICOURT
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Credential | APRN
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Telephone | 404-926-6114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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