MEDICARE: MRS. GAYE S FICARROTTA ARNP CNM

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	176B00000X	Midwife	1817222	FL
2	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	ME1817222	FL
3	367A00000X	Advanced Practice Midwife	ARNP1817222	FL

General Provider Information

NPI Number	:	1205141215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GAYE S FICARROTTA ARNP CNM

Provider Business Mailing Address
First Line	:	PO BOX 25317
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33622-5317
Country	:	US
Telephone Number	:	813-286-0033
Fax Number	:	813-282-1806

Provider Business Practice Location Address
First Line	:	4705 ALT 19
Second Line	:	SUITE B
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-1440
Country	:	US
Telephone Number	:	727-935-6477
Fax Number	:	727-935-6478

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

Provider Enumeration Date	:	08/13/2010
Last Update Date	:	08/30/2016

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