Healthcare Provider Details
I. General information
NPI: 1992114755
Provider Name (Legal Business Name): JESSICA ALOYO OWLES ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/06/2014
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14000 FIVAY RD
HUDSON FL
34667-7103
US
IV. Provider business mailing address
19360 ROSEATE DR
LUTZ FL
33558-2333
US
V. Phone/Fax
- Phone: 727-819-2929
- Fax:
- Phone: 813-309-3480
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | ARNP 9302283 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: