MEDICARE: MISHELE MCFADDEN 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	363LF0000X	Family Nurse Practitioner	APRN11043092	FL

General Provider Information

NPI Number	:	1669332219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISHELE MCFADDEN FNP-BC

Provider Business Mailing Address
First Line	:	3702 W SPRUCE ST # 1696
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-2553
Country	:	US
Telephone Number	:	813-819-2611
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 W CASS ST # 208
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-1349
Country	:	US
Telephone Number	:	813-819-2611
Fax Number	:

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

Provider Enumeration Date	:	11/17/2025
Last Update Date	:	11/17/2025

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