MEDICARE: MS. ANNE CATHERINE OPUDA 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	911112	FL

General Provider Information

NPI Number	:	1295840122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNE CATHERINE OPUDA ARNP

Provider Business Mailing Address
First Line	:	825 NW 23RD AVE
Second Line	:	BLDG III SUITE A
City	:	GAINESVILLE
State	:	FL
Zip	:	32609-3574
Country	:	US
Telephone Number	:	352-376-1611
Fax Number	:	352-248-0270

Provider Business Practice Location Address
First Line	:	825 NW 23RD AVE
Second Line	:	BLDG III SUITE A
City	:	GAINESVILLE
State	:	FL
Zip	:	32609-3574
Country	:	US
Telephone Number	:	352-376-1611
Fax Number	:	352-248-0270

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	05/22/2008

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