# ELITE PEDIATRIC HEALTHCARE, LLC

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

## Provider details

- **NPI number:** 1962000174
- **Authorized official:** RHONDA NICHOLS MCGREW APRN, NP-C (NURSE PRACTITIONER/CO-OWNER)
- **Authorized official phone:** (251) 610-5615

## Contact information

- **Practice address:** 673 S KINGS AVENUE, BRANDON, FL 33511
- **Practice address phone:** (251) 610-5615
- **Mailing address:** 19046 BRUCE B DOWNS BLVD \# 1397, TAMPA, FL 33647

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0200X | Pediatric Nurse Practitioner | — | NULL | Yes |
| 363LP0200X | Pediatric Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/12/2020
- **Last updated:** 05/08/2021