| Innovative Healthy Aging, LLC | |
|
1120 Pinellas Bayway S Ste 105 Tierra Verde FL 33715-1500 | |
| (727) 282-9724 | |
| (727) 317-0043 |
| Full Name | Innovative Healthy Aging, LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 1120 Pinellas Bayway S Ste 105, Tierra Verde, Florida |
| Authorized Official Name and Position | Teresa Annette Nesbit (NURSE PRACTIONER) |
| Authorized Official Contact | 7272829724 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Healthy Aging, LLC 841 2nd Ave S Tierra Verde FL 33715-2249 Ph: (407) 421-6600 | Innovative Healthy Aging, LLC 1120 Pinellas Bayway S Ste 105 Tierra Verde FL 33715-1500 Ph: (727) 282-9724 |
| NPI Number | 1669158929 |
|---|---|
| Provider Enumeration Date | 06/22/2023 |
| Last Update Date | 03/20/2024 |
| Certification Date | 03/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669158929 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |