MEDICARE: HEALTHCARE EXTRAORDINARE, LLC

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	363L00000X	Nurse Practitioner

Other Identifiers

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

General Provider Information

NPI Number	:	1780273474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCARE EXTRAORDINARE, LLC

Provider Business Mailing Address
First Line	:	3154 HIGHLAND GROVE DR
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32065-6855
Country	:	US
Telephone Number	:	904-613-6974
Fax Number	:	904-375-2012

Provider Business Practice Location Address
First Line	:	3154 HIGHLAND GROVE DR
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32065-6855
Country	:	US
Telephone Number	:	904-613-6974
Fax Number	:	904-375-2012

Authorized Official
Title or Position	:	DNP/APRN
Name	:	DR. TANA ROBINSON
Credential	:	APRN
Telephone Number	:	904-613-3974

Provider Enumeration Date	:	01/16/2021
Last Update Date	:	03/02/2026

Similar Medicare Providers

1174798433 — ORANGE COUNTY NEWBORN MEDICARE CARE PC
Practice Location Address:

3 SAINT STEPHENS PL , SUITE 2
WARWICK, NY
10990-3208

Practice Phone: 845-987-9700
Practice Fax:

1427089259 — NATIONAL VISION, INC.
Practice Location Address:

6855 NEW HAMPSHIRE AVE
TAKOMA PARK, MD
20912-4816

Practice Phone: 301-891-6861
Practice Fax: 301-891-6892

1720124340 — DR. RICHARD ANTHONY BATTISTONI DDS
Practice Location Address:

6855 W NORTH AVE
OAK PARK, IL
60302

Practice Phone: 708-848-5900
Practice Fax: 708-848-0315

1376766451 — DRS BATTISTONI & BEAM LTD
Practice Location Address:

6855 W NORTH AVE
OAK PARK, IL
60302

Practice Phone: 708-848-5900
Practice Fax: 708-848-0315

1598988594 — WILLIAM BEAM DDS, MS
Practice Location Address:

6855 NORTH AVE , DRS BATTISTONI AND BEAM
OAK PARK, IL
60302-1023

Practice Phone: 708-848-5900
Practice Fax:

1881123990 — NICOLE SHARRETTE STENNETT OD
Practice Location Address:

6855 NEW HAMPSHIRE AVE
TAKOMA PARK, MD
20912-4816

Practice Phone: 301-891-6861
Practice Fax:

Directions to “HEALTHCARE EXTRAORDINARE, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.