MEDICARE: MRS. DEYSI AGUILERA RN, BSN, 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	363LP2300X	Primary Care Nurse Practitioner	ARNP9407603	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538487046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEYSI AGUILERA RN, BSN, ARNP

Provider Business Mailing Address
First Line	:	6408 N ARMENIA AVE STE B-1
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-5770
Country	:	US
Telephone Number	:	813-352-8305
Fax Number	:

Provider Business Practice Location Address
First Line	:	6408 N ARMENIA AVE STE B-1
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-5770
Country	:	US
Telephone Number	:	813-352-8305
Fax Number	:

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

Provider Enumeration Date	:	05/07/2010
Last Update Date	:	04/14/2020

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