MEDICARE: AARIKA DANIELLE GLAWSON APRN

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	363LG0600X	Gerontology Nurse Practitioner	11007768	FL
2	363L00000X	Nurse Practitioner	APRN11007768	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	:	1538785654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AARIKA DANIELLE GLAWSON APRN

Provider Business Mailing Address
First Line	:	38135 MARKET SQ
Second Line	:
City	:	ZEPHYRHILLS
State	:	FL
Zip	:	33542-7505
Country	:	US
Telephone Number	:	352-567-0188
Fax Number	:	813-355-5101

Provider Business Practice Location Address
First Line	:	3000 MEDICAL PARK DR STE 190
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-6601
Country	:	US
Telephone Number	:	813-778-0288
Fax Number	:	813-783-1309

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

Provider Enumeration Date	:	06/24/2020
Last Update Date	:	06/04/2021

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