Individual
SIERRA HOPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4736 68TH AVE N, PINELLAS PARK, FL 33781-5263
(727) 291-3294
Mailing address
4736 68TH AVE N, PINELLAS PARK, FL 33781-5263
(727) 291-3294
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105722900
—
FL
Enumeration date
03/31/2020
Last updated
03/31/2020
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