| P31 Life Llc | |
|
7901 4th St N Ste 300 Saint Petersburg FL 33702-4399 | |
| (305) 924-5397 | |
| Not Available |
| Full Name | P31 Life Llc |
|---|---|
| Speciality | Nurse Practitioner - Psychiatric/mental Health |
| Location | 7901 4th St N Ste 300, Saint Petersburg, Florida |
| Authorized Official Name and Position | Dianne Smith (OWNER) |
| Authorized Official Contact | 8634557300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| P31 Life Llc 7901 4th St N Ste 300 Saint Petersburg FL 33702-4399 Ph: (305) 924-5397 | P31 Life Llc 7901 4th St N Ste 300 Saint Petersburg FL 33702-4399 Ph: (305) 924-5397 |
| NPI Number | 1336819788 |
|---|---|
| Provider Enumeration Date | 09/16/2021 |
| Last Update Date | 09/23/2021 |
| Certification Date | 09/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336819788 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
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