Provider Demographics
NPI:1851878094
Name:NURSE PRACTITIONERS OF PINELLAS, LLC.
Entity Type:Organization
Organization Name:NURSE PRACTITIONERS OF PINELLAS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RONSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:727-290-6116
Mailing Address - Street 1:3551 42ND AVENUE SOUTH SUITE B107
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33711-4369
Mailing Address - Country:US
Mailing Address - Phone:727-290-6116
Mailing Address - Fax:727-290-6762
Practice Address - Street 1:3551 42ND AVENUE SOUTH SUITE B107
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33711-4369
Practice Address - Country:US
Practice Address - Phone:727-290-6116
Practice Address - Fax:727-290-6762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-20
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherCOMMERCIALS