Provider Demographics
NPI:1679285423
Name:ON ML'S WATCH LLC
Entity Type:Organization
Organization Name:ON ML'S WATCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY LYNN
Authorized Official - Middle Name:TEETER
Authorized Official - Last Name:GUARINO
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:727-276-6809
Mailing Address - Street 1:2834 11TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-5502
Mailing Address - Country:US
Mailing Address - Phone:727-276-6809
Mailing Address - Fax:888-864-4428
Practice Address - Street 1:2834 11TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-5502
Practice Address - Country:US
Practice Address - Phone:727-276-6809
Practice Address - Fax:888-864-4428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-22
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty