Provider Demographics
NPI:1780855056
Name:GRIFFITH, VERONICA TANTOCO (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:TANTOCO
Last Name:GRIFFITH
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 1:4354 NW 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6541
Mailing Address - Country:US
Mailing Address - Phone:352-548-1102
Mailing Address - Fax:
Practice Address - Street 1:4354 NW 23RD AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6541
Practice Address - Country:US
Practice Address - Phone:352-548-1102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3212542363L00000X, 363LF0000X
FL3212542363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL305908100Medicaid
FLE0218VMedicare PIN