Individual
JUSTIN RAY FRANK LAWANDALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
3000 MEDICAL PARK DR, SUITE 500, TAMPA, FL 33613-4680
(813) 615-7028
(813) 615-8008
Mailing address
3000 MEDICAL PARK DR, SUITE 500, TAMPA, FL 33613-4680
(813) 615-7028
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN9316431
FL
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN9316431
FL
363LG0600X
Gerontology Nurse Practitioner
ARNP9316431
FL
Other
Enumeration date
07/18/2016
Last updated
10/08/2020
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