Provider Demographics
NPI:1720651821
Name:HEALTHCARE MADE FOR YOU LLC
Entity Type:Organization
Organization Name:HEALTHCARE MADE FOR YOU LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ALISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIMMAGE
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:727-291-2829
Mailing Address - Street 1:1750 16TH ST S UNIT 35207
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-8009
Mailing Address - Country:US
Mailing Address - Phone:813-644-9372
Mailing Address - Fax:
Practice Address - Street 1:1750 16TH ST S
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-8000
Practice Address - Country:US
Practice Address - Phone:813-644-9362
Practice Address - Fax:727-499-6912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty