Provider Demographics
NPI:1447842695
Name:LTSU HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:LTSU HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP APRN
Authorized Official - Phone:941-720-6985
Mailing Address - Street 1:4301 32ND ST W STE C2
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-2748
Mailing Address - Country:US
Mailing Address - Phone:941-713-2429
Mailing Address - Fax:
Practice Address - Street 1:4301 32ND ST W STE C2
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-2748
Practice Address - Country:US
Practice Address - Phone:941-713-2429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care