MEDICARE: ALINA ANN COLLEARY

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	11008633	FL

General Provider Information

NPI Number	:	1679175855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALINA ANN COLLEARY

Provider Business Mailing Address
First Line	:	3010 S WEST SHORE BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-7641
Country	:	US
Telephone Number	:	954-260-1341
Fax Number	:

Provider Business Practice Location Address
First Line	:	17504 PRESERVE WALK LN # 2061
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3243
Country	:	US
Telephone Number	:	813-528-7012
Fax Number	:

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

Provider Enumeration Date	:	11/12/2020
Last Update Date	:	07/20/2023

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Directions to “ ALINA ANN COLLEARY ” Practice Location

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