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NPI Code Detail

MEDICARE: TERESA LYNNE MASSARO ARNP

MEDICARE: TERESA LYNNE MASSARO ARNP
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
1363LA2200XAdult Health Nurse Practitioner1377702FL

General Provider Information

NPI Number : 1770566036
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA LYNNE MASSARO ARNP
Provider Business Mailing Address
First Line : 18643 SAN RIO CIR
Second Line :
City : LUTZ
State : FL
Zip : 33549-3918
Country : US
Telephone Number : 813-949-2686
Fax Number :
Provider Business Practice Location Address
First Line : 4200 W CYPRESS ST STE 690
Second Line :
City : TAMPA
State : FL
Zip : 33607-4112
Country : US
Telephone Number : 813-877-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2005
Last Update Date : 02/05/2020

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