Provider Demographics
NPI:1376052332
Name:LAVIANA, BRITTANY (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:LAVIANA
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3251 3RD AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8506
Mailing Address - Country:US
Mailing Address - Phone:727-494-7625
Mailing Address - Fax:
Practice Address - Street 1:18167 US 19 N STE 150
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-6566
Practice Address - Country:US
Practice Address - Phone:727-494-7625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11004421363LF0000X
SC21279363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL113738700Medicaid