Provider Demographics
NPI:1376271684
Name:KEEP IT REAL HEALTHCARE LLC
Entity type:Organization
Organization Name:KEEP IT REAL HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, ARNP
Authorized Official - Phone:321-334-3742
Mailing Address - Street 1:7901 4TH ST N # 13695
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4305
Mailing Address - Country:US
Mailing Address - Phone:321-334-3742
Mailing Address - Fax:480-864-6048
Practice Address - Street 1:6470 WAY POINT BLVD
Practice Address - Street 2:
Practice Address - City:HARMONY
Practice Address - State:FL
Practice Address - Zip Code:34773-6160
Practice Address - Country:US
Practice Address - Phone:321-334-3742
Practice Address - Fax:480-864-6048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-13
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty