Provider Demographics
NPI:1629701792
Name:TRANQUILITY MENTAL HEALTH & WELLNESS, LLC
Entity Type:Organization
Organization Name:TRANQUILITY MENTAL HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP-BC, FNP-
Authorized Official - Phone:727-683-6868
Mailing Address - Street 1:15985 PRESERVE MARKETPLACE BLVD UNIT 107
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-5509
Mailing Address - Country:US
Mailing Address - Phone:727-683-6868
Mailing Address - Fax:727-205-5448
Practice Address - Street 1:2430 ESTANCIA BLVD STE 106
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2607
Practice Address - Country:US
Practice Address - Phone:727-416-2845
Practice Address - Fax:727-205-5448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-06
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty