Provider Demographics
NPI:1659115012
Name:CARDONA JARROSAY, ZEIDA
Entity type:Individual
Prefix:
First Name:ZEIDA
Middle Name:
Last Name:CARDONA JARROSAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6402 N GRADY AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-4821
Mailing Address - Country:US
Mailing Address - Phone:813-401-0361
Mailing Address - Fax:
Practice Address - Street 1:6402 N GRADY AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-4821
Practice Address - Country:US
Practice Address - Phone:813-401-0361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF06240899363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily