MEDICARE: AFFORDABLE FAMILY NURSE PRACTITIONERS OF TAMPA BAY 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	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1952178980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFORDABLE FAMILY NURSE PRACTITIONERS OF TAMPA BAY LLC

Provider Business Mailing Address
First Line	:	6407 DOE PATH CT
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33545-4867
Country	:	US
Telephone Number	:	813-701-7162
Fax Number	:

Provider Business Practice Location Address
First Line	:	6407 DOE PATH CT
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33545-4867
Country	:	US
Telephone Number	:	813-701-7162
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. MARILYN ACHIENG ALUOCH
Credential	:	APRN
Telephone Number	:	813-701-7162

Provider Enumeration Date	:	12/11/2023
Last Update Date	:	12/11/2023

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