Organization
THE RESTORATIVE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUKAINA NICOPHENE (MNS, APRP, FNP-C, PMHNP-C)
(813) 598-0652
Entity
Organization
Contact information
Practice address
100 S ASHLEY DR STE 600-2324, TAMPA, FL 33602-5304
(813) 598-0653
Mailing address
10705 OLD SYCAMORE LOOP, LAND O LAKES, FL 34638-4989
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/23/2025
Last updated
08/23/2025
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