MEDICARE: CLAUDIA MARIA FUENTES MELGAR 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	363LA2100X	Acute Care Nurse Practitioner	APRN11002200	FL
2	363LG0600X	Gerontology Nurse Practitioner	APRN11002200	FL

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

General Provider Information

NPI Number	:	1619531316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDIA MARIA FUENTES MELGAR APRN

Provider Business Mailing Address
First Line	:	9320 US HIGHWAY 301 S STE 350
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33578-6300
Country	:	US
Telephone Number	:	813-328-2070
Fax Number	:

Provider Business Practice Location Address
First Line	:	9320 US HIGHWAY 301 S STE 350
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33578-6300
Country	:	US
Telephone Number	:	813-328-2070
Fax Number	:

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

Provider Enumeration Date	:	04/28/2019
Last Update Date	:	04/06/2026

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