Provider Demographics
NPI:1568129930
Name:RODRIGUEZ TUDELA, ANIUSKA (ARNP)
Entity type:Individual
Prefix:
First Name:ANIUSKA
Middle Name:
Last Name:RODRIGUEZ TUDELA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5352 N HABANA AVE STE D
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-6838
Mailing Address - Country:US
Mailing Address - Phone:813-999-1103
Mailing Address - Fax:813-999-1373
Practice Address - Street 1:5352 N HABANA AVE STE D
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-6838
Practice Address - Country:US
Practice Address - Phone:813-999-1103
Practice Address - Fax:813-999-1373
Is Sole Proprietor?:No
Enumeration Date:2021-11-20
Last Update Date:2024-11-01
Deactivation Date:2021-11-20
Deactivation Code:
Reactivation Date:2021-12-16
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016193363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily