Provider Demographics
NPI:1275512998
Name:TARVAINEN, ANITA (ARNP)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:TARVAINEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:958 S DIXIE HWY
Mailing Address - Street 2:LANTANA FAMILY CARE CENTER, INC.
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462-4653
Mailing Address - Country:US
Mailing Address - Phone:561-528-6564
Mailing Address - Fax:
Practice Address - Street 1:958 S DIXIE HWY
Practice Address - Street 2:LANTANA FAMILY CARE CENTER, INC.
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-4653
Practice Address - Country:US
Practice Address - Phone:561-528-6564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2993952363L00000X
FLRN 2993952363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN 2993952OtherARNP
FLE5829Medicare ID - Type UnspecifiedARNP