Healthcare Provider Details

I. General information

NPI: 1194719500
Provider Name (Legal Business Name): ROSEMARY PERKINS ASHBY , MS, ARNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 06/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13000 BRUCE B DOWNS BLVD 111B
TAMPA FL
33612-4745
US

IV. Provider business mailing address

13000 BRUCE B DOWNS BLVD 111B
TAMPA FL
33612-4745
US

V. Phone/Fax

Practice location:
  • Phone: 813-972-2000
  • Fax: 913-903-4812
Mailing address:
  • Phone: 813-972-2000
  • Fax: 913-903-4812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number67856-2
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WG0100X
TaxonomyGastroenterology Registered Nurse
License Number67856-2
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: