Provider Demographics
NPI:1063481554
Name:MCGAUVRAN, RITA (APRN)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:
Last Name:MCGAUVRAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:M
Other - Last Name:MCGAUVRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3000 MEDICAL PARK DR STE 490
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-6600
Mailing Address - Country:US
Mailing Address - Phone:813-971-2470
Mailing Address - Fax:813-971-2491
Practice Address - Street 1:3000 MEDICAL PARK DR STE 490
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-6600
Practice Address - Country:US
Practice Address - Phone:813-971-2470
Practice Address - Fax:813-971-2491
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012445363L00000X
VA0024171754363LF0000X
FLAPRN11009209363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47077295213Medicaid
NE47077295213Medicaid