Organization
PASSPORT HEALTH OF TAMPA BAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DUELLYN Z. PANDIS DNP APRN, FNP-C (EXECUTIVE DIRECTOR)
(813) 969-3757
Entity
Organization
Contact information
Practice address
4204 W LINEBAUGH AVE, TAMPA, FL 33624-5241
(813) 969-3757
(813) 969-3052
Mailing address
4204 W LINEBAUGH AVE, TAMPA, FL 33624-5241
(813) 969-3757
(813) 969-3052
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
RN2855132
FL
Other
Enumeration date
08/20/2008
Last updated
09/01/2020
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