Provider Demographics
NPI:1346936630
Name:ARENTZ, EMILY J (APRN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:J
Last Name:ARENTZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:17654 MEADOWBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-5528
Mailing Address - Country:US
Mailing Address - Phone:609-287-0970
Mailing Address - Fax:
Practice Address - Street 1:2 TAMPA GENERAL CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3571
Practice Address - Country:US
Practice Address - Phone:813-259-0619
Practice Address - Fax:813-259-0620
Is Sole Proprietor?:No
Enumeration Date:2023-04-11
Last Update Date:2024-01-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11024100363LA2200X, 363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL118454900Medicaid
FLDX4Z4OtherBCBS