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NPI Code Detail

MEDICARE: JUAN JOSE OTAZU ARNP

MEDICARE: JUAN JOSE OTAZU 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
1363LF0000XFamily Nurse PractitionerARNP9290738FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ARNP9290738OTHERFLARNP

General Provider Information

NPI Number : 1336531045
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUAN JOSE OTAZU ARNP
Provider Business Mailing Address
First Line : 10521 PARKCREST DR
Second Line :
City : TAMPA
State : FL
Zip : 33624-5023
Country : US
Telephone Number : 813-767-7276
Fax Number :
Provider Business Practice Location Address
First Line : 8726 W WATERS AVE
Second Line :
City : TAMPA
State : FL
Zip : 33615-1714
Country : US
Telephone Number : 813-712-1726
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2015
Last Update Date : 11/02/2021

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Directions to “ JUAN JOSE OTAZU ARNP” Practice Location

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