MEDICARE: HILDA OBI-ANADIUME

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	11012352	FL

General Provider Information

NPI Number	:	1376123687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HILDA OBI-ANADIUME

Provider Business Mailing Address
First Line	:	5414 TOWN N COUNTRY BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-4120
Country	:	US
Telephone Number	:	813-230-4410
Fax Number	:

Provider Business Practice Location Address
First Line	:	5414 TOWN N COUNTRY BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-4120
Country	:	US
Telephone Number	:	813-230-4410
Fax Number	:

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

Provider Enumeration Date	:	04/11/2021
Last Update Date	:	04/11/2021

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