Provider Demographics
NPI:1164128286
Name:FLORIDA NP HEALTHCARE CLINIC
Entity Type:Organization
Organization Name:FLORIDA NP HEALTHCARE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIGSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-898-0226
Mailing Address - Street 1:13117 ELK MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-7184
Mailing Address - Country:US
Mailing Address - Phone:813-898-0226
Mailing Address - Fax:813-898-0239
Practice Address - Street 1:13117 ELK MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-7184
Practice Address - Country:US
Practice Address - Phone:813-898-0226
Practice Address - Fax:813-898-0239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty