Largo Wellness Primary Care

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

LARGO WELLNESS PRIMARY CARE

Practice address

415 7TH Ave SW
Largo, FL 33770-3400

Phone

(727) 501-1040

NPI assigned

Sep 18, 2017

Reactivated

Sep 26, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mickoria Smith

Title

Chief Operating Officer

Phone

(561) 420-7501

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537920000000",
    "number": "1245759596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 7TH AVE SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 7TH AVE SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703400",
            "telephone_number": "727-501-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARGO WELLNESS PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-18",
        "last_updated": "2018-09-26",
        "deactivation_date": "2018-08-15",
        "reactivation_date": "2018-09-26",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MICKORIA",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "561-420-7501"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Largo Primary Care LLC
• Largo Radiology Consultants
• Largo Radiology Consultants, PA
• Largo Surgery LLC
• Largo Urgent Care
• Athanasios Kevin Larkin, DO
• Larry J Feinman DO PA
• Valerie Anne Lasko, M.D.
• Brent Joseph Lataille, ARNP
• Kate Michele Lauer, APRN

• Primary Care Nurse Practitioner in Largo, FL
• Providers in Largo, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.