Provider Demographics
NPI:1710968912
Name:TAMAN, MERNAMIE CASTARDO (ARNP/NURSE PRACTITIO)
Entity Type:Individual
Prefix:MRS
First Name:MERNAMIE
Middle Name:CASTARDO
Last Name:TAMAN
Suffix:
Gender:F
Credentials:ARNP/NURSE PRACTITIO
Other - Prefix:
Other - First Name:MERNAMIE
Other - Middle Name:CASTARDO
Other - Last Name:CUNAMAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:115 LATERRA LINKS CIR UNIT 101
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-3526
Mailing Address - Country:US
Mailing Address - Phone:909-200-9014
Mailing Address - Fax:904-809-3141
Practice Address - Street 1:1601 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1135
Practice Address - Country:US
Practice Address - Phone:904-213-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2023-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP124079363LA2200X, 363LF0000X
FLAPRN11023649363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health