Provider Demographics
NPI:1396439634
Name:AMBRUSO, TAYLOR WHITNEY (APRN)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:WHITNEY
Last Name:AMBRUSO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5400 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-3833
Mailing Address - Country:US
Mailing Address - Phone:352-277-5305
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:1111 7TH AVE N STE 107
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1348
Practice Address - Country:US
Practice Address - Phone:727-894-6703
Practice Address - Fax:727-894-1430
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLRN9488668163W00000X
FLAPRN11026838363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse