Basic Information
Provider Information
NPI: 1538785654
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GLAWSON
FirstName: AARIKA
MiddleName: DANIELLE
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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Mailing Information
Address1: 38135 MARKET SQ
Address2:  
City: ZEPHYRHILLS
State: FL
PostalCode: 335427505
CountryCode: US
TelephoneNumber: 3525670188
FaxNumber: 8133555101
Practice Location
Address1: 3000 MEDICAL PARK DR STE 190
Address2:  
City: TAMPA
State: FL
PostalCode: 336136601
CountryCode: US
TelephoneNumber: 8137780288
FaxNumber: 8137831309
Other Information
ProviderEnumerationDate: 06/24/2020
LastUpdateDate: 06/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LG0600X11007768FLN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
363L00000XAPRN11007768FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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