Provider Demographics
NPI:1902297963
Name:JANUSKA, AIMEE (ARNP)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:JANUSKA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:
Other - Last Name:CROWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2901 58TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33714
Mailing Address - Country:US
Mailing Address - Phone:727-822-4300
Mailing Address - Fax:727-456-1399
Practice Address - Street 1:3003 W. MLK BLVD
Practice Address - Street 2:MAB 3RD FL.
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-870-4948
Practice Address - Fax:813-870-4770
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9325057363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014323900Medicaid