MEDICARE: JAYNE HOWARD TOPOLSKI RN

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	163WA2000X	Administrator Registered Nurse	1439282	FL

General Provider Information

NPI Number	:	1760537724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYNE HOWARD TOPOLSKI RN

Provider Business Mailing Address
First Line	:	14461 116TH AVE
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33774-3825
Country	:	US
Telephone Number	:	727-643-6255
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 W KENNEDY BLVD
Second Line	:	114
City	:	TAMPA
State	:	FL
Zip	:	33609-2288
Country	:	US
Telephone Number	:	813-639-1915
Fax Number	:	813-514-4715

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

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	07/08/2007

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