Provider Demographics
NPI:1295159259
Name:AUSSENDORF, MARIA MAGDALENA (RN)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:MAGDALENA
Last Name:AUSSENDORF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:MAGDALENA
Other - Last Name:VAZQUEZ-AUSSENDORF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:4814 N DARBY AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-2604
Mailing Address - Country:US
Mailing Address - Phone:813-598-7711
Mailing Address - Fax:813-641-9278
Practice Address - Street 1:4814 N DARBY AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-2604
Practice Address - Country:US
Practice Address - Phone:813-598-7711
Practice Address - Fax:813-641-9278
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9188861163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health