MEDICARE: MS. MICHELLE G LEVARGE 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	363LA2200X	Adult Health Nurse Practitioner	ARNP 9168834	FL

General Provider Information

NPI Number	:	1427023076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE G LEVARGE ARNP

Provider Business Mailing Address
First Line	:	8971 IRON OAK AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3161
Country	:	US
Telephone Number	:	813-973-7622
Fax Number	:

Provider Business Practice Location Address
First Line	:	11707 CLUB DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-5521
Country	:	US
Telephone Number	:	814-631-7123
Fax Number	:

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

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	02/23/2009

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