Healthcare Provider Details

I. General information

NPI: 1689661282
Provider Name (Legal Business Name): TARA HAMILTON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 02/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3554 1ST AVE N
ST PETERSBURG FL
33713-8402
US

IV. Provider business mailing address

9305 120TH LN
SEMINOLE FL
33772-2636
US

V. Phone/Fax

Practice location:
  • Phone: 727-321-4846
  • Fax: 727-321-3811
Mailing address:
  • Phone: 727-392-0985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP 2966472
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberARNP2966472
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: