Healthcare Provider Details

I. General information

NPI: 1265455174
Provider Name (Legal Business Name): ROSE NIEVES ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4506 N ARMENIA AVE
TAMPA FL
33603-2732
US

IV. Provider business mailing address

4506 N ARMENIA AVE
TAMPA FL
33603-2732
US

V. Phone/Fax

Practice location:
  • Phone: 813-879-3530
  • Fax: 813-874-6608
Mailing address:
  • Phone: 813-879-3530
  • Fax: 813-874-6608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberARNP3088602
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: