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Organization
LARGO WELLNESS PRIMARY CARE
Active
Organization
LARGO WELLNESS PRIMARY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICKORIA SMITH (CHIEF OPERATING OFFICER)
(561) 420-7501
Entity
Organization
Contact information
Practice address
415 7TH AVE SW, LARGO, FL 33770-3400
(727) 501-1040
Mailing address
415 7TH AVE SW, LARGO, FL 33770-3400
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/18/2017
Last updated
09/26/2018
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