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Organization
ST JOSEPHS HOPSITAL
Active
Organization
ST JOSEPHS HOPSITAL
Active
Other names
SJN Neonates
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYNDA GORKEN (VP)
(727) 281-9390
Entity
Organization
Contact information
Practice address
4211 VAN DYKE RD, LUTZ, FL 33558-8002
(813) 443-2010
Mailing address
2995 DREW ST FL 2, CLEARWATER, FL 33759-3012
(727) 281-9390
(813) 635-2613
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
Enumeration date
02/08/2012
Last updated
03/04/2020
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