Provider Demographics
NPI:1821013327
Name:FINE, ANN B (ARNP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:B
Last Name:FINE
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 1:1111 7TH AVE N
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1348
Mailing Address - Country:US
Mailing Address - Phone:727-822-5393
Mailing Address - Fax:727-895-3313
Practice Address - Street 1:1111 7TH AVE N
Practice Address - Street 2:SUITE 103
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1348
Practice Address - Country:US
Practice Address - Phone:727-822-5393
Practice Address - Fax:727-895-3313
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2009942363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics