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NPI Code Detail

MEDICARE: ELIZABETH SHOMBERG MARCINSKI IMH

MEDICARE: ELIZABETH SHOMBERG MARCINSKI IMH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH21549FL

General Provider Information

NPI Number : 1174168975
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH SHOMBERG MARCINSKI IMH
Provider Business Mailing Address
First Line : 1389 MILTON ST
Second Line :
City : CLEARWATER
State : FL
Zip : 33756-4282
Country : US
Telephone Number : 727-475-9531
Fax Number :
Provider Business Practice Location Address
First Line : 2963 GULF TO BAY BLVD STE 320
Second Line :
City : CLEARWATER
State : FL
Zip : 33759-4286
Country : US
Telephone Number : 727-367-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2019
Last Update Date : 06/02/2023

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