MEDICARE: SANDRA JOY TECSON NEVAREZ NP

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	339347	NY
2	363LF0000X	Family Nurse Practitioner	0024177155	VA
3	363LF0000X	Family Nurse Practitioner	APRN11006108	FL

General Provider Information

NPI Number	:	1801268248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA JOY TECSON NEVAREZ NP

Provider Business Mailing Address
First Line	:	1343 MONTGOMERY BELL RD
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-0016
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2727 W DR MARTIN LUTHER KING JR BLVD STE 720
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6378
Country	:	US
Telephone Number	:	813-405-4338
Fax Number	:

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

Provider Enumeration Date	:	10/26/2015
Last Update Date	:	11/02/2023

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