Healthcare Provider Details

I. General information

NPI: 1386969897
Provider Name (Legal Business Name): YATSEN SYUN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MINGJUAN SUN ARNP

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10335 CROSS CREEK BLVD # H20
TAMPA FL
33647-2795
US

IV. Provider business mailing address

9103 MOUNTAIN MAGNOLIA DR
RIVERVIEW FL
33578-8677
US

V. Phone/Fax

Practice location:
  • Phone: 813-388-6838
  • Fax: 813-388-9526
Mailing address:
  • Phone: 813-388-6838
  • Fax: 813-388-9526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number9268058
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: