Provider Demographics
NPI:1932529948
Name:MSB INTEGRATIVE PRIMARY CARE LLC
Entity Type:Organization
Organization Name:MSB INTEGRATIVE PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BRITT
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:727-447-3434
Mailing Address - Street 1:12002 ANCHOR WAY
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-2507
Mailing Address - Country:US
Mailing Address - Phone:386-682-9644
Mailing Address - Fax:
Practice Address - Street 1:29901 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-1041
Practice Address - Country:US
Practice Address - Phone:727-286-6203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-17
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2672012363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty