MEDICARE: LAUREN ASHLEY TZAMTZIS AG-ACNP

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	11014882	FL

General Provider Information

NPI Number	:	1790444651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ASHLEY TZAMTZIS AG-ACNP

Provider Business Mailing Address
First Line	:	5624 SW 60TH AVE
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33143-2232
Country	:	US
Telephone Number	:	305-632-1299
Fax Number	:

Provider Business Practice Location Address
First Line	:	14150 SW 136TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-5506
Country	:	US
Telephone Number	:	305-632-1299
Fax Number	:

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

Provider Enumeration Date	:	12/08/2021
Last Update Date	:	12/08/2021

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