Individual
DOREY PASSMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 TAMPA GENERAL CIR FL 6, TAMPA, FL 33606-3571
(813) 259-0619
Mailing address
1163 36TH AVE NE, ST PETERSBURG, FL 33704-1615
(727) 482-4790
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
11030912
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121417700
—
FL
01
—
5A1W0
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/30/2024
Last updated
04/17/2024
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