MEDICARE: MRS. ANGELICA LYNN LOEBENBERG ARNP

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	363L00000X	Nurse Practitioner	ARNP9294173	FL

General Provider Information

NPI Number	:	1194291377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELICA LYNN LOEBENBERG ARNP

Provider Business Mailing Address
First Line	:	2815 1ST AVE N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33713-8641
Country	:	US
Telephone Number	:	727-321-9614
Fax Number	:	727-323-7068

Provider Business Practice Location Address
First Line	:	2815 1ST AVE N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33713-8641
Country	:	US
Telephone Number	:	727-321-9614
Fax Number	:	727-323-7068

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

Provider Enumeration Date	:	10/16/2018
Last Update Date	:	05/21/2026

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