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General NPI Number Information
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NPI Number | 1063696763
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Entity Type | Individual
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Provider Name | NYARAI CHINYANI MUSHONGA MD
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Gender | Female
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Dates
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Enumeration Date | 12/18/2007
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Last Update Date | 06/14/2024
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Provider Practice Location Address
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Address Line | 700 6TH ST S FL 2
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City | ST PETERSBURG
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State | FL
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Zip | 33701-4815
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Country | US
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Telephone | 727-553-7461
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Fax | 727-553-7462
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Provider Business Mailing Address
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Address Line | 700 6TH ST S FL 2
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City | ST PETERSBURG
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State | FL
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Zip | 33701-4815
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Country | US
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Telephone | 727-553-7461
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Fax | 727-553-7462
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2088F0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
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License Number | ME124118
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | MD471825
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD471825
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MA09160500
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 2088F0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
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License Number | 25MA09160500
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License Number State | NJ
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