# SEASIDE WELLNESS PRIMARY CARE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023864121
- **Authorized official:** KRISTA B SHENKMAN (OWNER)
- **Authorized official phone:** (727) 270-5047

## Contact information

- **Practice address:** 7531 ULMERTON RD, LARGO, FL 33771-4548
- **Practice address phone:** (727) 270-5047
- **Practice address fax:** (727) 877-3735
- **Mailing address:** 7531 ULMERTON RD, LARGO, FL 33771-4548
- **Mailing address phone:** (727) 270-5047
- **Mailing address fax:** (727) 877-3735

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LG0600X | Gerontology Nurse Practitioner | — | NULL | Yes |
| 363LG0600X | Gerontology Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/29/2024
- **Last updated:** 04/29/2026