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Organization

LIFESTREAM VIRTUAL PRIMARY CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ARIEL VARELA (NURSE PRACTITIONER)
(813) 240-9696
Entity
Organization

Contact information

Practice address
7901 4TH ST N # 24609, ST PETERSBURG, FL 33702-4305
(813) 240-9696
Mailing address
7901 4TH ST N # 24609, ST PETERSBURG, FL 33702-4305
(813) 240-9696

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Enumeration date
12/10/2024
Last updated
12/13/2024
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