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General NPI Number Information
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NPI Number | 1700026184
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Entity Type | Individual
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Provider Name | JESSICA B LOSADA ARNP
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Gender | Female
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Dates
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Enumeration Date | 02/25/2009
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Last Update Date | 08/03/2018
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Provider Practice Location Address
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Address Line | 602 VONDERBURG DR STE 103
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City | BRANDON
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State | FL
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Zip | 33511
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Country | US
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Telephone | 727-456-3288
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Fax | 727-456-3289
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Provider Business Mailing Address
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Address Line | 602 VONDERBURG DR STE 103
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City | BRANDON
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State | FL
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Zip | 33511-5900
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Country | US
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Telephone | 813-720-8001
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Fax | 813-445-8168
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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 | ARNP9266376
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License Number State | FL
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