Provider Demographics
NPI:1750921722
Name:ALBINO, TINA MARIE (ARNP-FNP)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE
Last Name:ALBINO
Suffix:
Gender:F
Credentials:ARNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 N PALM AVE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4827
Mailing Address - Country:US
Mailing Address - Phone:321-746-4560
Mailing Address - Fax:
Practice Address - Street 1:1032 MANN ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4121
Practice Address - Country:US
Practice Address - Phone:407-518-7277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-08
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005638363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily