Healthcare Provider Details

I. General information

NPI: 1861939688
Provider Name (Legal Business Name): NEITZA MERCEDES HOOPER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2017
Last Update Date: 03/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6726 HANLEY RD
TAMPA FL
33634-4739
US

IV. Provider business mailing address

3 WILLOUGHBY PL
PALM COAST FL
32164-7621
US

V. Phone/Fax

Practice location:
  • Phone: 813-284-7903
  • Fax:
Mailing address:
  • Phone: 386-846-8137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 9401651
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: