Provider Demographics
NPI:1568129930
Name:RODRIGUEZ TUDELA, ANIUSKA (ARNP)
Entity Type:Individual
Prefix:
First Name:ANIUSKA
Middle Name:
Last Name:RODRIGUEZ TUDELA
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 1:9304 ATTENBURY DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-1659
Mailing Address - Country:US
Mailing Address - Phone:281-409-4629
Mailing Address - Fax:
Practice Address - Street 1:9304 ATTENBURY DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-1659
Practice Address - Country:US
Practice Address - Phone:281-409-4629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-20
Last Update Date:2021-12-16
Deactivation Date:2021-11-20
Deactivation Code:
Reactivation Date:2021-12-16
Provider Licenses
StateLicense IDTaxonomies
FL11016193363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner