Provider Demographics
NPI:1710278890
Name:VIEIRA, DAMARIS RODRIGUEZ (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DAMARIS
Middle Name:RODRIGUEZ
Last Name:VIEIRA
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 1:1505 E MULBERRY DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-3451
Mailing Address - Country:US
Mailing Address - Phone:813-936-3216
Mailing Address - Fax:
Practice Address - Street 1:7108 CAUSEWAY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-6364
Practice Address - Country:US
Practice Address - Phone:813-628-4400
Practice Address - Fax:813-628-4500
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2031172363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP 2031172OtherNURSE PRACTITIONER LICENSE