Provider Demographics
NPI:1710793914
Name:PETERS VARGAS, KYSVEL DARELSI (ARNP)
Entity type:Individual
Prefix:MISS
First Name:KYSVEL
Middle Name:DARELSI
Last Name:PETERS VARGAS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9456 CHARLESBERG DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-1637
Mailing Address - Country:US
Mailing Address - Phone:813-770-9781
Mailing Address - Fax:
Practice Address - Street 1:4700 N HABANA AVE STE 702
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7122
Practice Address - Country:US
Practice Address - Phone:813-872-0613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11026355363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health