Provider Demographics
NPI:1003585209
Name:RAVAL, TARYN N (APRN)
Entity Type:Individual
Prefix:
First Name:TARYN
Middle Name:N
Last Name:RAVAL
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:352-567-0188
Mailing Address - Fax:
Practice Address - Street 1:5 TAMPA GENERAL CIR STE 830
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3658
Practice Address - Country:US
Practice Address - Phone:813-251-5511
Practice Address - Fax:813-377-1707
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11002752363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner