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General NPI Number Information
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NPI Number | 1710968912
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Entity Type | Individual
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Provider Name | MERNAMIE CASTARDO TAMAN ARNP/NURSE PRACTITIO
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Gender | Female
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 9310 OLD KINGS RD S STE 1303
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City | JACKSONVILLE
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State | FL
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Zip | 32257-8100
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Country | US
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Telephone | 904-900-3472
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Fax |
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Provider Business Mailing Address
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Address Line | 115 LATERRA LINKS CIR UNIT 101
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-3526
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Country | US
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Telephone | 909-200-9014
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP124079
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11023649
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN11023649
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License Number State | FL
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