Healthcare Provider Details

I. General information

NPI: 1922787001
Provider Name (Legal Business Name): TATIANA PACHECO MSN, APRN, A-GNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2023
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35095 US HIGHWAY 19 N STE 100
PALM HARBOR FL
34684-1968
US

IV. Provider business mailing address

35095 US HIGHWAY 19 N STE 100
PALM HARBOR FL
34684-1968
US

V. Phone/Fax

Practice location:
  • Phone: 727-953-8404
  • Fax: 813-635-7866
Mailing address:
  • Phone: 727-953-8404
  • Fax: 813-635-7866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11026975
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: