Provider Demographics
NPI:1184153322
Name:MANATEE AREA CONVENIENT CARE CLINIC, INC.
Entity type:Organization
Organization Name:MANATEE AREA CONVENIENT CARE CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:PAPPALARDO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, NP-C
Authorized Official - Phone:941-705-3811
Mailing Address - Street 1:100 PALMVIEW RD LOT 68
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-9358
Mailing Address - Country:US
Mailing Address - Phone:941-705-3811
Mailing Address - Fax:
Practice Address - Street 1:100 PALMVIEW RD LOT 68
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-9358
Practice Address - Country:US
Practice Address - Phone:941-705-3811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-10
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1988502363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty