MEDICARE: DR. SANDRA L RISOLDI DNP, AAPRN, PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11017154	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	403913	NY

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972745206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANDRA L RISOLDI DNP, AAPRN, PMHNP

Provider Business Mailing Address
First Line	:	35054 US HIGHWAY 19 N
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-1925
Country	:	US
Telephone Number	:	727-223-3424
Fax Number	:	727-295-1648

Provider Business Practice Location Address
First Line	:	35054 US HIGHWAY 19 N
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-1925
Country	:	US
Telephone Number	:	727-223-3424
Fax Number	:	727-295-1648

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

Provider Enumeration Date	:	04/01/2009
Last Update Date	:	07/23/2024

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