Healthcare Provider Details

I. General information

NPI: 1609249168
Provider Name (Legal Business Name): JESSICA LILAH OPRISIU ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2015
Last Update Date: 04/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 S HUEY AVE
TARPON SPRINGS FL
34689-4205
US

IV. Provider business mailing address

PO BOX 10549
ST PETERSBURG FL
33733-0549
US

V. Phone/Fax

Practice location:
  • Phone: 727-824-8181
  • Fax: 727-939-4679
Mailing address:
  • Phone: 727-824-8181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberARNP 9406107
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: