Provider Demographics
NPI:1316462823
Name:GARGASZ, MARILYN ALETHEA (APRN)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:ALETHEA
Last Name:GARGASZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARILYN
Other - Middle Name:ALETHA
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3000 MEDICAL PARK DR STE 500
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-6600
Mailing Address - Country:US
Mailing Address - Phone:813-615-7007
Mailing Address - Fax:813-615-8350
Practice Address - Street 1:3000 MEDICAL PARK DR STE 500
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613
Practice Address - Country:US
Practice Address - Phone:813-615-7007
Practice Address - Fax:813-615-8350
Is Sole Proprietor?:No
Enumeration Date:2017-08-04
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9259568363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily