MEDICARE: DR. THERESA MARIE WEBB APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN9165978	FL
2	363LF0000X	Family Nurse Practitioner	ARNP9165978	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033652615
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THERESA MARIE WEBB APRN

Provider Business Mailing Address
First Line	:	5015 W NASSAU ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-3814
Country	:	US
Telephone Number	:	813-356-0196
Fax Number	:	813-356-0197

Provider Business Practice Location Address
First Line	:	1142 BELL SHOALS RD
Second Line	:
City	:	BRANDON
State	:	FL
Zip	:	33511-8909
Country	:	US
Telephone Number	:	813-685-0827
Fax Number	:	813-685-0968

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2016
Last Update Date	:	12/03/2024

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