OrganizationActive
Specialized Care Initiative PLLC
NPI 1255179743 · Adult Health Nurse Practitioner · New Port Richey, FL
Provider details
- NPI number
- 1255179743
- Entity type
- Organization
- Primary specialty
- Adult Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Jeffrey Wacksman, Authorized Official(855) 232-0644
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
Practice location
8348 Little Rd Ste 149
New Port Richey, FL 34654-4919
Phone: (855) 232-0644
Approximate (ZIP-level) locationGet directions
Mailing address
8348 Little Road
New Port Richey, FL 34654-4919
Registry dates
- Enumerated
- 2024-07-18
- Last updated
- 2024-07-18
- Certified
- 2024-07-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.