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General NPI Number Information
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NPI Number | 1760660732
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Entity Type | Individual
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Provider Name | BRENDA JO GAMBLE RN
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Gender | Female
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Dates
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Enumeration Date | 02/01/2008
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Last Update Date | 02/01/2008
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Provider Practice Location Address
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Address Line | 13000 BRUCE B DOWNS BLVD JAMES A HALEY VETERANS' HOSPITAL-UNIT 5WEST
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City | TAMPA
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State | FL
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Zip | 33612-4745
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Country | US
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Telephone | 813-972-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 17757 ESPRIT DR
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City | TAMPA
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State | FL
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Zip | 33647-2509
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Country | US
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Telephone | 813-907-7151
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Fax | 813-907-7151
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN 9215362
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WC3500X
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Taxonomy Name | Cardiac Rehabilitation Registered Nurse
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License Number | R 131668-3
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License Number State | MN
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