Healthcare Provider Details

I. General information

NPI: 1154392207
Provider Name (Legal Business Name): ROSALINDA TIONGCO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 TAMPA GENERAL CIR
TAMPA FL
33606-3571
US

IV. Provider business mailing address

7109 HARVEST GLEN LN
RIVERVIEW FL
33578-8643
US

V. Phone/Fax

Practice location:
  • Phone: 813-821-8038
  • Fax: 813-974-0483
Mailing address:
  • Phone: 813-842-8353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberARNP9197202
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9197202
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN9197202
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: