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NPI Code Detail

MEDICARE: MRS. DAMARIS RODRIGUEZ VIEIRA ARNP

MEDICARE:  MRS. DAMARIS RODRIGUEZ VIEIRA  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
1363LA2200XAdult Health Nurse PractitionerARNP2031172FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ARNP 2031172OTHERFLNURSE PRACTITIONER LICENSE

General Provider Information

NPI Number : 1710278890
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DAMARIS RODRIGUEZ VIEIRA ARNP
Provider Business Mailing Address
First Line : 1505 E MULBERRY DR
Second Line :
City : TAMPA
State : FL
Zip : 33604-3451
Country : US
Telephone Number : 813-936-3216
Fax Number :
Provider Business Practice Location Address
First Line : 7108 CAUSEWAY BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33619-6364
Country : US
Telephone Number : 813-628-4400
Fax Number : 813-628-4500
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2011
Last Update Date : 04/25/2011

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