LIFE EXTENSION CLINICS, INC


Address: 1011 N Macdill Ave, Tampa, FL 33607-5126
Phone: 8138760625

LIFE EXTENSION CLINICS, INC (NPI# 1376869073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1376869073
Entity Type Organization
Organization Name LIFE EXTENSION CLINICS, INC
Other Organization Name LIFE SCAN WELLNESS CENTERS
Practice Address 1011 N Macdill Ave
Tampa
FL 33607-5126
Practice Telephone 8138760625
Practice Fax Number 8138760653
Mailing Telephone 8138760625
Mailing Fax Number 8138760653
Enumeration Date 2010-04-20
Last Update Date 2010-04-20
Authorized Official Name PATRICIA JOHNSON (CEO)
Authorized Official Telephone 8138760625
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WG0000X Registered Nurse
Specialization: General Practice
RN1456802 FL Nursing Service Providers

Other Provider/Organization Names

Other Name Type Code
Life Scan Wellness Centers Doing Business As Name - Organization

Other Data Sources

Entity Type Entity Name Entity Address
Washington State Corporations LIFE EXTENSION CLINICS, INC. 1011 N Macdill Ave, Tampa, FL 33607-5126
Colorado Business Entities Life Extension Clinics, Inc. 1011 North Macdill Ave., Yampa, FL 33607

Office Location

Street Address 1011 N MACDILL AVE
City TAMPA
State FL
Zip Code 33607-5126

Providers in the same location

NPI Name Taxonomy Address Enumeration
1215535737 Amy Koehler Nurse Practitioner 1011 N Macdill Ave, Tampa, FL 33607-5126 2020-10-16
1306495387 Barbara Ann Palinchik Nurse Practitioner 1011 N Macdill Ave, Tampa, FL 33607-5126 2019-09-11
1376190785 Marci Vitale Nurse Practitioner 1011 N Macdill Ave, Tampa, FL 33607-5126 2019-08-20
1740748987 Jennifer Lopez Nurse Practitioner 1011 N Macdill Ave, Tampa, FL 33607-5126 2019-03-06
1366942708 Lisa Marie Simms Nurse Practitioner 1011 N Macdill Ave, Tampa, FL 33607-5126 2018-02-12
1679014401 Kathryn Bacher Nurse Practitioner 1011 N Macdill Ave, Tampa, FL 33607-5126 2017-03-13

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1326656265 Sky City Pharmacy LLC Pharmacy 2812 W. Dr Martin Luther King Jr Blvd, Tampa, FL 33607 2020-07-16
1821614413 Tammy Sue Alleyn Social Worker 4414 N. Armenia Av., Tampa, FL 33607 2020-06-19
1912528290 Advanced Mobile Medical Services Clinic/Center 2136 W. Mlk Blvd, Tampa, FL 33607 2020-04-28
1659909232 Rachel Sobiech Social Worker 2006 Pan Am Circle, Suite 270, Tampa, FL 33607 2020-03-30
1295379733 Melizza Liz Sanchez Ayala Registered Nurse 1701 N Lois Avenue, Valera Apt Unit 224, Tampa, FL 33607 2019-10-28
1720647191 Caretyme LLC Clinic/Center 1923 West St. John Street, Tampa, FL 33607 2019-06-10
1720545981 Amante Medical and Diabetic Center, P.a. Internal Medicine 1001 N Macdill Ave. Suite B, Tampa, FL 33607 2019-02-25
1609360908 Misty Dawn Ray Ross Social Worker 2902 N Armenia Ave Ste 200, Tampa, FL 33607 2018-06-20
1255825154 Kenneth Konrad Schirer Physical Therapist 2700 W Dr. Mlk Blvd, Suite 300, Tampa, FL 33607 2018-06-14
1902314875 Cardiac Cin of Florida, LLC Internal Medicine 3001 W Martin Luther King Jr Blvd, Tampa, FL 33607 2018-01-13
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Taxonomy Information

Taxonomy Code 163WG0000X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization General Practice

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1942642301 Yanet D. Perez Parra Registered Nurse 6821 W Hillsborough Ave Ste 10-11, Tampa, FL 33634 2013-07-25
1902158611 Christopher Colton Mitchell Registered Nurse 1109 W Peninsular St, Tampa, FL 33603-5213 2012-10-04
1326038621 Alice H Pandolfi Registered Nurse 14602 Corkwood Dr, Tampa, FL 33626-2334 2005-10-27
1861093759 Alma Escalona Registered Nurse 5707 N 22nd St, Tampa, FL 33610-4350 2020-11-05
1215407671 Mayelin Gonzalez Registered Nurse 205 W Busch Blvd, Tampa, FL 33612-7900 2018-11-28
1093284507 Tiffany Kendra Whiting Registered Nurse 1 Tampa General Cir, Tampa, FL 33606-3571 2018-11-14
1669920237 Miguel Mestre Jr. Registered Nurse 13000 Bruce B Downs Blvd, Tampa, FL 33612-4745 2016-09-13
1316902323 Ileana Fernandez Registered Nurse 13000 Bruce B Downs Blvd, Cardiology 111-a, Tampa, FL 33612-4745 2006-04-20
1326041419 Penny G Lee Registered Nurse 1 Tampa General Cir, Hmt Cardiology, Tampa, FL 33606-3571 2005-05-23

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1073113973 Carlos Josue Felico Pupo Sr. Registered Nurse 10405 Old Cutler Rd Apt 202, Cutler Bay, FL 33190-1708 2020-10-29
1659979920 Kelsey Coons Registered Nurse 1105 Shenandoah Ct, Marco Island, FL 34145-5021 2020-10-09
1134736085 Kenneth E Knowles Registered Nurse 1515 E Hewett Rd, Santa Rosa Beach, FL 32459-3348 2020-09-24
1043826688 Gregory Wade Prince Registered Nurse 1790 Waterside Oaks Dr, Orange City, FL 32763-9206 2020-09-18
1699381483 Charissa Elizabeth Carroll Registered Nurse 1639 Songbird Ct, Naples, FL 34120-1652 2020-09-17
1447862586 Teresa Koliha Registered Nurse 4251 N Bay Rd, Miami Beach, FL 33140-2844 2020-08-19
1295344604 Portia Williams Registered Nurse 2225 Sw Newport Isles Blvd, Port St Lucie, FL 34953-4575 2020-07-31
1093323610 Linda Marie Mcmurray Registered Nurse 1539 Parental Home Rd Ste 5, Jacksonville, FL 32216-3009 2020-07-20
1255949160 Maria A Oliver Registered Nurse 8365 Sw 152nd Ave Apt C-108, Miami, FL 33193-4028 2020-07-16
1700401635 Dakota Sharon Phillips Wheeler Registered Nurse 5045 Kirkwood Trl, Titusville, FL 32780-6717 2020-06-16
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Competitor

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City TAMPA
Zip Code 33607

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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