Provider Demographics
NPI:1003674292
Name:MAGNANIMITY RESOURCE HEALTH
Entity Type:Organization
Organization Name:MAGNANIMITY RESOURCE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLIPPS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-BC
Authorized Official - Phone:813-317-1787
Mailing Address - Street 1:5401 W KENNEDY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-2457
Mailing Address - Country:US
Mailing Address - Phone:813-317-1787
Mailing Address - Fax:
Practice Address - Street 1:5401 W KENNEDY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2457
Practice Address - Country:US
Practice Address - Phone:813-317-1787
Practice Address - Fax:813-762-1471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health