Provider Demographics
NPI:1265499768
Name:EARP, PAULA J (PA-C)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:J
Last Name:EARP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10150 HIGHLAND MANOR DR STE 205
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-9727
Mailing Address - Country:US
Mailing Address - Phone:813-259-1013
Mailing Address - Fax:813-254-0396
Practice Address - Street 1:10150 HIGHLAND MANOR DR STE 205
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-9727
Practice Address - Country:US
Practice Address - Phone:813-259-1013
Practice Address - Fax:813-254-0396
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9111832363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41966200Medicaid
P83385Medicare UPIN
WI41966200Medicaid
WI082674150Medicare PIN
WI082674150Medicare PIN