Provider Demographics
NPI:1255096459
Name:XPRESS HOUSE CALLS, LLC
Entity type:Organization
Organization Name:XPRESS HOUSE CALLS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-785-8944
Mailing Address - Street 1:11767 S DIXIE HWY # 146
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-4438
Mailing Address - Country:US
Mailing Address - Phone:305-422-1008
Mailing Address - Fax:
Practice Address - Street 1:15 PARADISE PLZ # 147
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-6905
Practice Address - Country:US
Practice Address - Phone:305-422-1008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN2573872OtherFL LICENSE