Individual
IDA MARILOU HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2730 N MCMULLEN BOOTH RD STE 201, CLEARWATER, FL 33761-3302
(727) 725-5224
(727) 799-2183
Mailing address
2730 N MCMULLEN BOOTH RD STE 201, CLEARWATER, FL 33761-3302
(727) 725-5224
(727) 799-2183
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ARNP1512312
FL
363L00000X
Nurse Practitioner
Primary
ARNP1512312
FL
363LF0000X
Family Nurse Practitioner
ARNP 1512312
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300796100
—
FL
Enumeration date
01/12/2007
Last updated
08/17/2021
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