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General NPI Number Information
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NPI Number | 1881065175
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Entity Type | Individual
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Provider Name | ANNA ZAVYAZKINA NP
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Gender | Female
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Dates
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Enumeration Date | 10/12/2015
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 901 45TH ST
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City | MANGONIA PARK
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State | FL
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Zip | 33407-2413
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Country | US
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Telephone | 561-882-6186
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Fax | 561-882-6124
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Provider Business Mailing Address
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Address Line | 18167 US HIGHWAY 19 N STE 650
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City | CLEARWATER
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State | FL
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Zip | 33764-6576
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Country | US
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Telephone | 727-507-3635
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Fax | 727-474-4648
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | ARNP9294066
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | APRN9294066
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License Number State | FL
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