MEDICARE: THERESA M HIRVIMAKI ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	ARNP2516622	FL

General Provider Information

NPI Number	:	1184733750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA M HIRVIMAKI ARNP

Provider Business Mailing Address
First Line	:	315 75TH ST W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-3201
Country	:	US
Telephone Number	:	941-761-1998
Fax Number	:	941-748-5626

Provider Business Practice Location Address
First Line	:	7005 CORTEZ RD W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34210-2509
Country	:	US
Telephone Number	:	941-792-2122
Fax Number	:	941-798-2019

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	05/14/2010

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