Provider Demographics
NPI:1578070868
Name:PAILES, BETH MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:MARIE
Last Name:PAILES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:MARIE
Other - Last Name:RASKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:4400 W SPRUCE ST APT 185
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-4155
Mailing Address - Country:US
Mailing Address - Phone:662-648-8083
Mailing Address - Fax:
Practice Address - Street 1:1 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:813-844-3547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-08
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9349634363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner