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NPI Code Detail

MEDICARE: TRANQUILITY MENTAL HEALTH & WELLNESS, LLC

MEDICARE: TRANQUILITY MENTAL HEALTH & WELLNESS, LLC
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
1363LF0000XFamily Nurse Practitioner
2363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1629701792
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRANQUILITY MENTAL HEALTH & WELLNESS, LLC
Provider Business Mailing Address
First Line : 15985 PRESERVE MARKETPLACE BLVD UNIT 107
Second Line :
City : ODESSA
State : FL
Zip : 33556-5509
Country : US
Telephone Number : 727-683-6868
Fax Number : 727-205-5448
Provider Business Practice Location Address
First Line : 2430 ESTANCIA BLVD STE 106
Second Line :
City : CLEARWATER
State : FL
Zip : 33761-2607
Country : US
Telephone Number : 727-416-2845
Fax Number : 727-205-5448
Authorized Official
Title or Position : OWNER/PROVIDER
Name : LISA ANN LOWE
Credential : APRN, PMHNP-BC, FNP-
Telephone Number : 727-683-6868
Provider Enumeration Date : 07/06/2022
Last Update Date : 10/20/2022

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