Provider Demographics
NPI:1619531316
Name:FUENTES MELGAR, CLAUDIA MARIA (APRN)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:MARIA
Last Name:FUENTES MELGAR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 EXECUTIVE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-5323
Mailing Address - Country:US
Mailing Address - Phone:727-347-0005
Mailing Address - Fax:727-541-6558
Practice Address - Street 1:2919 W SWANN AVE STE 106
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4049
Practice Address - Country:US
Practice Address - Phone:813-930-2829
Practice Address - Fax:813-930-9522
Is Sole Proprietor?:No
Enumeration Date:2019-04-28
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11002200363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care