Provider Demographics
NPI:1740209857
Name:WHITE, MARIA ROSE (APRN)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ROSE
Last Name:WHITE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:ROSE
Other - Last Name:BOLOGNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:38135 MARKET SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7539
Mailing Address - Country:US
Mailing Address - Phone:813-284-2220
Mailing Address - Fax:813-377-1718
Practice Address - Street 1:2740 WINDGUARD CIR STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-7363
Practice Address - Country:US
Practice Address - Phone:813-284-2220
Practice Address - Fax:813-377-1718
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN2675742363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP2675742OtherARNP LICENSE
FLP45362Medicare UPIN
FLY0343XMedicare ID - Type Unspecified