Individual
BRENT JOSEPH LATAILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
3500 OAK MANOR LN, LARGO, FL 33774-1211
(727) 488-5915
Mailing address
13541 87TH PL, SEMINOLE, FL 33776-2615
(727) 488-5915
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP 9261217
FL
Other
Enumeration date
01/24/2017
Last updated
04/19/2019
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