=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992354955
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MAJLINDA RAKIPI HOLMES ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2019
-----------------------------------------------------
Last Update Date | 09/11/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8787 BRYAN DAIRY RD STE 230
-----------------------------------------------------
City | LARGO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33777-1258
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-541-4426
-----------------------------------------------------
Fax | 727-546-8753
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8787 BRYAN DAIRY RD STE 230
-----------------------------------------------------
City | LARGO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33777-1258
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-541-4426
-----------------------------------------------------
Fax | 727-546-8753
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 11003111
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------