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General NPI Number Information
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NPI Number | 1295057719
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Entity Type | Individual
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Provider Name | MICHELE E PEDULLA ARNP
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Gender | Female
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Dates
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Enumeration Date | 02/25/2010
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Last Update Date | 03/13/2020
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Provider Practice Location Address
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Address Line | 5411 GRAND BLVD SUITE 102
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-4010
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Country | US
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Telephone | 727-849-2535
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Fax | 727-849-7157
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Provider Business Mailing Address
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Address Line | 1802 CLEARBROOKE DR
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City | CLEARWATER
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State | FL
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Zip | 33760-1429
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Country | US
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Telephone | 727-849-2535
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Fax | 727-849-7157
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | ARNP1658012
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License Number State | FL
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