Healthcare Provider Details

I. General information

NPI: 1770746489
Provider Name (Legal Business Name): ESTHER MARIE VERDERICO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 6TH ST S
ST PETERSBURG FL
33701-4816
US

IV. Provider business mailing address

14236 85TH AVE
SEMINOLE FL
33776-2831
US

V. Phone/Fax

Practice location:
  • Phone: 727-898-7451
  • Fax:
Mailing address:
  • Phone: 727-954-7868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number3320932
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: