MEDICARE: LAURA Y PULIDO APRN

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	363LF0000X	Family Nurse Practitioner	APRN1570142	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00865875	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	Y04FR	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1295730059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA Y PULIDO APRN

Provider Business Mailing Address
First Line	:	3005 W EUCLID AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-8954
Country	:	US
Telephone Number	:	813-508-1859
Fax Number	:	656-222-7471

Provider Business Practice Location Address
First Line	:	3005 W EUCLID AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-8954
Country	:	US
Telephone Number	:	813-508-1859
Fax Number	:

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	12/16/2025

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