MEDICARE: TATJANA JAKOVLEV

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	363LF0000X	Family Nurse Practitioner	APRN11044693	FL

General Provider Information

NPI Number	:	1285591719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TATJANA JAKOVLEV

Provider Business Mailing Address
First Line	:	25247 GEDDY DR
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-5674
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13172 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2406
Country	:	US
Telephone Number	:	813-374-8981
Fax Number	:

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

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/13/2026

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