Healthcare Provider Details

I. General information

NPI: 1740488345
Provider Name (Legal Business Name): IRIS NORMA CONCEPCION ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 11/18/2022
Certification Date: 11/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8145 CEREBELLUM WAY STE 101&102
TRINITY FL
34655-1788
US

IV. Provider business mailing address

8145 CEREBELLUM WAY STE 101&102
TRINITY FL
34655-1788
US

V. Phone/Fax

Practice location:
  • Phone: 727-845-4999
  • Fax: 866-777-2195
Mailing address:
  • Phone: 727-845-4999
  • Fax: 866-777-2195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberARNP9254985
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: