Provider Demographics
NPI:1023697869
Name:HONOR 1ST NURSE PRACTITIONER PRIMARY CARE LLC
Entity type:Organization
Organization Name:HONOR 1ST NURSE PRACTITIONER PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:407-921-2307
Mailing Address - Street 1:2724 VIA MURANO UNIT 631
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-3985
Mailing Address - Country:US
Mailing Address - Phone:407-921-2307
Mailing Address - Fax:
Practice Address - Street 1:1721 W FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-1820
Practice Address - Country:US
Practice Address - Phone:407-921-2307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-07
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care