Individual provider · Type 1 NPI

Modupe D. McIntosh, CPNP

Psychiatric/Mental Health Nurse Practitioner · Clearwater, FL

NPI number 1174522916 Active

Practice location

13577 Feather Sound Dr
Clearwater, FL 33762-2258

Call (904) 902-4408 Map

Fax (904) 420-4745

Mailing address

635 Beaver Ruin Rd NW, Suite B
Lilburn, GA 30047-3474

Other practice locations

  • 635 Beaver Ruin Rd NW, Suite B, Lilburn, GA 30047-3474 · (678) 807-2230

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner 363LP0200XRN092844 (GA)
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808XAPRN11031023 (FL)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1174522916

Modupe D. McIntosh, CPNP's National Provider Identifier is 1174522916, issued on Jul 14, 2005. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Clearwater, FL. The record was last updated on Mar 20, 2024.