Organization
NP EXTENDER SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
M SANDRA DAVANZO MBR ARNP (PRESIDENT)
(727) 465-8515
Entity
Organization
Contact information
Practice address
200 2ND AVE S, # 340, ST PETERSBURG, FL 33701-4313
(727) 465-8515
(727) 867-2119
Mailing address
200 2ND AVE S, # 340, ST PETERSBURG, FL 33701-4313
(727) 465-8515
(727) 867-2119
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
1740872
FL
Other
Enumeration date
04/12/2007
Last updated
08/22/2020
Update your record
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