Healthcare Provider Details

I. General information

NPI: 1710937610
Provider Name (Legal Business Name): BRIAN ANDREW WHITE ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 08/20/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8108 N NEBRASKA AVE
TAMPA FL
33604-3103
US

IV. Provider business mailing address

PO BOX 82969
TAMPA FL
33682-2969
US

V. Phone/Fax

Practice location:
  • Phone: 813-712-1930
  • Fax:
Mailing address:
  • Phone: 813-866-0930
  • Fax: 813-405-3924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9189421
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: