Provider Demographics
NPI:1740213784
Name:ABBOTT, PAULA F (CNP)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:F
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 N HABANA AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-7117
Mailing Address - Country:US
Mailing Address - Phone:813-513-3030
Mailing Address - Fax:
Practice Address - Street 1:4700 N HABANA AVE STE 201
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7117
Practice Address - Country:US
Practice Address - Phone:813-513-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11020052363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2653212Medicaid
OHNP79743Medicare PIN
OHQ70089Medicare UPIN