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NPI Code Detail

MEDICARE: CASEY PATERSON

MEDICARE:   CASEY  PATERSON
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner11042615FL

General Provider Information

NPI Number : 1487519385
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASEY PATERSON
Provider Business Mailing Address
First Line : 4830 W KENNEDY BLVD STE 600
Second Line :
City : TAMPA
State : FL
Zip : 33609-2584
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4830 W KENNEDY BLVD STE 600
Second Line :
City : TAMPA
State : FL
Zip : 33609-2584
Country : US
Telephone Number : 727-255-2203
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2025
Last Update Date : 05/03/2026

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Directions to “ CASEY PATERSON ” Practice Location

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