Healthcare Provider Details

I. General information

NPI: 1326845975
Provider Name (Legal Business Name): BENJAMIN CUPELLI APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2025
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 TAMPA GENERAL CIR STE 300
TAMPA FL
33606-3578
US

IV. Provider business mailing address

9925 AZALEA BLOOM WAY APT 101
RIVERVIEW FL
33578-4631
US

V. Phone/Fax

Practice location:
  • Phone: 813-251-0793
  • Fax:
Mailing address:
  • Phone: 919-744-6744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN11037977
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: