MEDICARE: MR. ROMUALD CLAUDE DELACROIX ARNP

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	363LA2200X	Adult Health Nurse Practitioner	ARNP 9229899	FL

General Provider Information

NPI Number	:	1891953162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROMUALD CLAUDE DELACROIX ARNP

Provider Business Mailing Address
First Line	:	19019 SILVERBROOK DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-1871
Country	:	US
Telephone Number	:	813-789-0500
Fax Number	:	813-333-2526

Provider Business Practice Location Address
First Line	:	19019 SILVERBROOK DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-1871
Country	:	US
Telephone Number	:	813-789-0500
Fax Number	:	813-333-2526

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

Provider Enumeration Date	:	05/23/2008
Last Update Date	:	05/23/2008

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