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Individual

MARY ELIZABETH MACDONALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
2550 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33607-6302
(813) 876-6483
Mailing address
4040 49TH ST N, ST PETERSBURG, FL 33709-5734
(727) 526-6483

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
0000026715
TN
363LP0200X
Pediatric Nurse Practitioner
Primary
APRN11024455
FL

Other

Enumeration date
10/22/2019
Last updated
03/23/2023
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