Healthcare Provider Details

I. General information

NPI: 1629877329
Provider Name (Legal Business Name): LAUREN E. SNIPES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2025
Last Update Date: 04/27/2025
Certification Date: 04/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 MEDICAL PARK DR STE 170
TAMPA FL
33613-6601
US

IV. Provider business mailing address

30502 TREYBURN LOOP
WESLEY CHAPEL FL
33543-7820
US

V. Phone/Fax

Practice location:
  • Phone: 813-421-2979
  • Fax:
Mailing address:
  • Phone: 423-596-8027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11036925
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: