MEDICARE: EKATERINA TYULENEVA APRN, FNP-BC

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	363L00000X	Nurse Practitioner	11046291	FL

General Provider Information

NPI Number	:	1528991601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EKATERINA TYULENEVA APRN, FNP-BC

Provider Business Mailing Address
First Line	:	4727 PURITAN CIR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33617-8342
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4727 PURITAN CIR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33617-8342
Country	:	US
Telephone Number	:	813-951-0247
Fax Number	:

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

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/23/2026

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