Provider Demographics
NPI:1750014171
Name:PULIDO-KIM, MARGRETHE (APRN)
Entity type:Individual
Prefix:
First Name:MARGRETHE
Middle Name:
Last Name:PULIDO-KIM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8114 FISHERMANS POINTE DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-1808
Mailing Address - Country:US
Mailing Address - Phone:813-476-9400
Mailing Address - Fax:
Practice Address - Street 1:3000 MEDICAL PARK DR STE 320
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4681
Practice Address - Country:US
Practice Address - Phone:813-910-0027
Practice Address - Fax:813-971-1286
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-04
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11018481363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care