Healthcare Provider Details

I. General information

NPI: 1629818547
Provider Name (Legal Business Name): ROSCHWISTA MARIE MUNIZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2024
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2711 LETAP CT UNIT 101
LAND O LAKES FL
34638-7265
US

IV. Provider business mailing address

4439 BEAUMARIS DR
LAND O LAKES FL
34638-7783
US

V. Phone/Fax

Practice location:
  • Phone: 813-279-2211
  • Fax:
Mailing address:
  • Phone: 785-307-0353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11033028
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: