Provider Demographics
NPI:1952178980
Name:AFFORDABLE FAMILY NURSE PRACTITIONERS OF TAMPA BAY LLC
Entity Type:Organization
Organization Name:AFFORDABLE FAMILY NURSE PRACTITIONERS OF TAMPA BAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:ACHIENG
Authorized Official - Last Name:ALUOCH
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:813-701-7162
Mailing Address - Street 1:6407 DOE PATH CT
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33545-4867
Mailing Address - Country:US
Mailing Address - Phone:813-701-7162
Mailing Address - Fax:
Practice Address - Street 1:6407 DOE PATH CT
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33545-4867
Practice Address - Country:US
Practice Address - Phone:813-701-7162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty