Provider Demographics
NPI:1528361532
Name:WILSON, RITA MARIA (ARNP)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:MARIA
Last Name:WILSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3030 NORTH ROCKY POINT DRIVE WEST
Mailing Address - Street 2:SUITE 670
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-5906
Mailing Address - Country:US
Mailing Address - Phone:813-289-6597
Mailing Address - Fax:813-289-6592
Practice Address - Street 1:3030 NORTH ROCKY POINT DRIVE WEST
Practice Address - Street 2:SUITE 670
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5906
Practice Address - Country:US
Practice Address - Phone:813-289-6597
Practice Address - Fax:813-289-6592
Is Sole Proprietor?:No
Enumeration Date:2010-12-13
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2807262363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily