Organization
GO GROW LIVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA HAND APRN (CEO)
(813) 407-6074
Entity
Organization
Contact information
Practice address
12015 WHITMARSH LN, TAMPA, FL 33626-1737
(813) 587-0605
Mailing address
12114 RUSTIC RIVER WAY, TAMPA, FL 33635-9534
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109361900
—
FL
Enumeration date
06/08/2021
Last updated
06/08/2021
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