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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558411223 NPPES
Florida MEDICAID 300796100

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