MEDICARE: ROSALY STEPHENS MSN, APRN-C

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	NP9371300	FL

General Provider Information

NPI Number	:	1750825568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSALY STEPHENS MSN, APRN-C

Provider Business Mailing Address
First Line	:	12932 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2806
Country	:	US
Telephone Number	:	813-510-0770
Fax Number	:	813-605-0041

Provider Business Practice Location Address
First Line	:	12932 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2806
Country	:	US
Telephone Number	:	813-510-0770
Fax Number	:	813-605-0041

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

Provider Enumeration Date	:	12/13/2016
Last Update Date	:	06/03/2026

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