Provider Demographics
NPI:1245693530
Name:YOUR BEST YOU, P.A.
Entity type:Organization
Organization Name:YOUR BEST YOU, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANP-BC
Authorized Official - Prefix:
Authorized Official - First Name:SHANI
Authorized Official - Middle Name:V
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, ANP-BC, CDE
Authorized Official - Phone:813-936-2609
Mailing Address - Street 1:15511 N FLORIDA AVE
Mailing Address - Street 2:SUITE 502
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1263
Mailing Address - Country:US
Mailing Address - Phone:813-936-2609
Mailing Address - Fax:
Practice Address - Street 1:15511 N FLORIDA AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1263
Practice Address - Country:US
Practice Address - Phone:813-936-2609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-04
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018411600Medicaid
FL018411600Medicaid