Healthcare Provider Details

I. General information

NPI: 1205141215
Provider Name (Legal Business Name): GAYE S FICARROTTA ARNP CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2010
Last Update Date: 08/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4705 ALT 19 SUITE B
PALM HARBOR FL
34683-1440
US

IV. Provider business mailing address

PO BOX 25317
TAMPA FL
33622-5317
US

V. Phone/Fax

Practice location:
  • Phone: 727-935-6477
  • Fax: 727-935-6478
Mailing address:
  • Phone: 813-286-0033
  • Fax: 813-282-1806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1817222
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberME1817222
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberARNP1817222
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: