Provider Demographics
NPI:1275088494
Name:SIMONETTI, ADINA FLEMING (AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:ADINA
Middle Name:FLEMING
Last Name:SIMONETTI
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:ADINA
Other - Middle Name:
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:135 1ST ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4383
Mailing Address - Country:US
Mailing Address - Phone:727-446-3021
Mailing Address - Fax:
Practice Address - Street 1:135 1ST ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4383
Practice Address - Country:US
Practice Address - Phone:727-446-3021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1040298363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health