Provider Demographics
NPI:1538879036
Name:AXXCESS HEALTHCARE OF FLORIDA LLC
Entity type:Organization
Organization Name:AXXCESS HEALTHCARE OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:813-205-6671
Mailing Address - Street 1:8710 SANDY PLAINS DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-8615
Mailing Address - Country:US
Mailing Address - Phone:813-205-6671
Mailing Address - Fax:
Practice Address - Street 1:8710 SANDY PLAINS DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-8615
Practice Address - Country:US
Practice Address - Phone:813-205-6671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-25
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty