Houston, Ida Marilou
Houston, Ida Marilou is an individual health care provider with primary practice located at 2730 N Mcmullen Booth Rd Ste 201 , Clearwater FL 33761-3302. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Houston, Ida Marilou can be contacted via phone (727) 725-5224.Contact Information
Primary practice address
2730 N Mcmullen Booth Rd Ste 201
Clearwater FL 33761-3302
Phone: (727) 725-5224
Fax: (727) 799-2183
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ARNP1512312 | Florida |
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | ARNP 1512312 | Florida |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | ARNP1512312 | Florida |
Profile Details
NPI number | 1558411223 |
---|---|
LBN Legal business name | Houston, Ida Marilou |
Credentials | ARNP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 12th, 2007 |
Last updated | Aug 17th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1558411223 | NPPES |
Florida | MEDICAID | 300796100 |
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