Provider Demographics
NPI:1952906703
Name:HOUSECALLS TAMPA BAY LLC
Entity Type:Organization
Organization Name:HOUSECALLS TAMPA BAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:727-831-8376
Mailing Address - Street 1:PO BOX 49106
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33743-9106
Mailing Address - Country:US
Mailing Address - Phone:727-269-5618
Mailing Address - Fax:727-265-3420
Practice Address - Street 1:531 MAIN ST STE K
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-3558
Practice Address - Country:US
Practice Address - Phone:727-831-8376
Practice Address - Fax:727-265-3420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty