1386298172 NPI number — FEMMEMPOWERMENT AND ADVOCACY

Table of content: (NPI 1386298172)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386298172 NPI number — FEMMEMPOWERMENT AND ADVOCACY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FEMMEMPOWERMENT AND ADVOCACY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386298172
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11125 PARK BLVD STE 104-129
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEMINOLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33772-4757
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
931-704-4540
Provider Business Mailing Address Fax Number:
727-362-1421

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
327 14TH AVE S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33701-5531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-828-6238
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/30/2019

Additional Information

Authorized Official

Authorized Official Last Name:
SIMMERMAN
Authorized Official First Name:
KAYLEE
Authorized Official Middle Name:
SHEA GARRETT
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
931-704-4540

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1144774563 . This is a "OUT OF NETWORK PROVIDER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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