Healthcare Provider Details

I. General information

NPI: 1528658440
Provider Name (Legal Business Name): ARIELL SHELBY KOLIBAS NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2021
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SW 1ST AVE
OCALA FL
34471-6504
US

IV. Provider business mailing address

1500 SW 1ST AVE
OCALA FL
34471-6504
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-2528
  • Fax:
Mailing address:
  • Phone: 407-303-2528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number4704368687
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberAPRN11030973
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: