Organization
IDEAL IMAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY ATALIG (ARNP)
(813) 748-1527
Entity
Organization
Contact information
Practice address
17504 PRESERVE WALK LN, TAMPA, FL 33647-3243
(813) 549-2299
Mailing address
17504 PRESERVE WALK LN, TAMPA, FL 33647-3243
(813) 549-2299
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
9294421
FL
Other
Enumeration date
12/26/2015
Last updated
12/26/2015
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