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General NPI Number Information
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NPI Number | 1407662646
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Entity Type | Individual
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Provider Name | ASHMITA GURAGAIN
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Gender | Female
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Dates
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Enumeration Date | 12/03/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 1007 E BOYER ST
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-5501
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Country | US
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Telephone | 727-772-5982
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Fax |
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Provider Business Mailing Address
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Address Line | 19145 WOOD SAGE DR
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City | TAMPA
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State | FL
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Zip | 33647-3098
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Country | US
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Telephone | 571-435-2300
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11036215
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License Number State | FL
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