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Provider Information for 1275742637

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Gender: FEMALE

Individual NPI: 1275742637

Calendar   Last Updated:  2011-07-22
  Certification Date: 


Name Value
NPI 1275742637
Enumeration Date 2007-05-22
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 4153 ALADAR CT
LAND O LAKES, FL 34639-3965
United States

Phone: 813-810-0730 | Fax:
View Map External Link
Primary Practice Address 13000 BRUCE B DOWNS BLVD
TAMPA, FL 33612-4745
United States

Phone: 813-972-2000 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Primary Taxonomy Selected Taxonomy State License Number
Yes 363LA2200X - Nurse Practitioner Adult Health FL ARNP 2802582