Individual
MR. RADOUANE LAKTIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
4202 E FOWLER AVE, TAMPA, FL 33620-8000
(813) 974-2331
Mailing address
10411 GOLDENBROOK WAY, TAMPA, FL 33647-3169
(813) 857-1181
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11031382
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121788700
—
FL
01
—
ERQTY
BLUE CROSS BLUE SHIELD
FL
Enumeration date
02/21/2024
Last updated
04/24/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us