Individual
TAM PHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 5TH ST S, ST PETERSBURG, FL 33701-4804
(727) 767-8181
(727) 767-8030
Mailing address
601 5TH ST S, ST PETERSBURG, FL 33701-4804
(727) 767-8181
(727) 767-8030
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
9295757
FL
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP9295757
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669895405
—
FL
Enumeration date
01/30/2014
Last updated
02/14/2016
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