Individual
POETCHANAPORN BUNDIT TONGDEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1106 DRUID RD S, SUITE 201, CLEARWATER, FL 33756-3846
(727) 584-6266
Mailing address
65 IRWIN ST W, SAFETY HARBOR, FL 34695-2240
(727) 798-2927
(727) 798-2927
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP1478712
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP1478712
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
609593
—
FL
Enumeration date
08/16/2013
Last updated
03/15/2016
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