| Liveactive Primary Care Tampa, Llc | |
|
8849 Hawbuck St Ste A New Port Richey FL 34655-9805 | |
| (913) 549-3884 | |
| Not Available |
| Full Name | Liveactive Primary Care Tampa, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 8849 Hawbuck St Ste A, New Port Richey, Florida |
| Authorized Official Name and Position | Shane Brethowr (CEO/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 9135493884 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liveactive Primary Care Tampa, Llc Po Box 1269 Bellevue NE 68005-1269 Ph: () - | Liveactive Primary Care Tampa, Llc 8849 Hawbuck St Ste A New Port Richey FL 34655-9805 Ph: (913) 549-3884 |
| NPI Number | 1558241588 |
|---|---|
| Provider Enumeration Date | 09/02/2025 |
| Last Update Date | 09/02/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558241588 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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