MEDICARE: TINA RIGSBY PROUSALIS A.R.N.P

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	4009700	KY
2	363LF0000X	Family Nurse Practitioner	2680462	FL
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1183108	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2680462	OTHER	FL	A.R.N.P. STATE OF FLORIDA DEPARTMENT OF HEALTH

General Provider Information

NPI Number	:	1366684979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA RIGSBY PROUSALIS A.R.N.P

Provider Business Mailing Address
First Line	:	4601 CHARLOTTE PARK DR STE 390
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-1900
Country	:	US
Telephone Number	:	704-529-6161
Fax Number	:	704-831-6097

Provider Business Practice Location Address
First Line	:	701 TALLEVAST RD.
Second Line	:	SUN HYDROLICS
City	:	SARASOTA
State	:	FL
Zip	:	34243
Country	:	US
Telephone Number	:	941-362-1300
Fax Number	:	941-362-1349

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

Provider Enumeration Date	:	03/27/2009
Last Update Date	:	12/12/2025

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Directions to “ TINA RIGSBY PROUSALIS A.R.N.P” Practice Location

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