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NPI Code Detail

MEDICARE: MARIA LEZCANO TOMMOLINO APRN

MEDICARE: MARIA LEZCANO TOMMOLINO 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
1363LF0000XFamily Nurse PractitionerAPRN11014129FL
2363LF0000XFamily Nurse PractitionerF06192611GA

Other Identifiers

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

General Provider Information

NPI Number : 1740894690
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA LEZCANO TOMMOLINO APRN
Provider Business Mailing Address
First Line : 14690 SPRING HILL DR STE 305
Second Line :
City : SPRING HILL
State : FL
Zip : 34609-8102
Country : US
Telephone Number : 352-277-5348
Fax Number : 352-606-2857
Provider Business Practice Location Address
First Line : 1990 N PROSPECT AVE
Second Line :
City : LECANTO
State : FL
Zip : 34461-9792
Country : US
Telephone Number : 352-527-6888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2020
Last Update Date : 02/04/2026

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