# NP EXTENDER SERVICE LLC

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

## Provider details

- **NPI number:** 1467676437
- **Authorized official:** M SANDRA DAVANZO MBR ARNP (PRESIDENT)
- **Authorized official phone:** (727) 465-8515

## Contact information

- **Practice address:** 200 2ND AVE S, \# 340, ST PETERSBURG, FL 33701-4313
- **Practice address phone:** (727) 465-8515
- **Practice address fax:** (727) 867-2119
- **Mailing address:** 200 2ND AVE S, \# 340, ST PETERSBURG, FL 33701-4313
- **Mailing address phone:** (727) 465-8515
- **Mailing address fax:** (727) 867-2119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LG0600X | Gerontology Nurse Practitioner | 1740872 | FL | Yes |

## Other

- **Enumeration date:** 04/12/2007
- **Last updated:** 08/22/2020