Healthcare Provider Details

I. General information

NPI: 1104788249
Provider Name (Legal Business Name): TAMARA DE LA CARIDAD FIDALGO SALGADO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6133 PARKSIDE MEADOW DR
TAMPA FL
33625-5760
US

IV. Provider business mailing address

6133 PARKSIDE MEADOW DR
TAMPA FL
33625-5760
US

V. Phone/Fax

Practice location:
  • Phone: 813-562-3279
  • Fax:
Mailing address:
  • Phone: 813-562-3279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11043432
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: