Unknown Individual – Nurse Practitioner, NPI 1104836246
Nurse Practitioner
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
4600, North Habana Avenue, Tampa, Hillsborough County, Florida, 33614, United States
SUITE 15
TAMPA, FL 336147112
Phone: (813) 870-4460
Fax: (813) 870-4459
Type: Mailing
3554, 1st Avenue North, Central Oak Park, Saint Petersburg, Pinellas County, Florida, 33713, United States
ST PETERSBURG, FL 337138402
Phone: (873) 866-0930
Fax: (727) 321-3811
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33614)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| Pediatric Medicine, Internal Medicine | FL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | FL |
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