MR. SHANE BENNETT (NPI# 1780198168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780198168 |
| Entity Type | Individual |
| Full Name | MR. SHANE BENNETT |
| Credential | ARNP |
| Practice Address |
2106 S Lois Ave Tampa FL 33629-5659 |
| Practice Telephone | 8138444200 |
| Mailing Telephone | 8138444200 |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2018-01-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | ARNP9323265 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2106 S LOIS AVE |
| City | TAMPA |
| State | FL |
| Zip Code | 33629-5659 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164412805 | Cynthia Goode | Physical Therapist | 2106 S Lois Ave, Tampa, FL 33629-5602 | 2005-10-25 |
| 1164769063 | Tampa General Medical Group Inc | Family Medicine | 2106 S Lois Ave, Fl 2, Tampa, FL 33629 | 2013-01-11 |
| 1659660009 | Shawn Derek Skaife | Family Medicine | 2106 S Lois Ave, Tampa, FL 33629-5659 | 2011-04-06 |
| 1104145705 | Omar Santana Hernandez | Internal Medicine | 2106 S Lois Ave, Tampa, FL 33629-5659 | 2010-05-20 |
| 1154577930 | Jason Moses Castro | Family Medicine | 2106 S Lois Ave, Tampa, FL 33629-5659 | 2008-08-13 |
| 1902003262 | Pina Panchal | Family Medicine | 2106 S Lois Ave, Tampa, FL 33629-5659 | 2007-06-29 |
| 1073692000 | Raphael Khorran | Family Medicine | 2106 S Lois Ave, Tampa, FL 33629-5659 | 2006-11-02 |
| 1851401582 | Shannon Bogle | Physical Therapist | 2106 S Lois Ave, Tampa, FL 33629-5659 | 2006-08-30 |
| 1285667253 | Antonio Duroy Farrales | Family Medicine | 2106 S Lois Ave, Tampa, FL 33629-5659 | 2006-07-10 |
| 1740242411 | Tower Imaging Inc | Radiology | 2106 S Lois Ave, Tower Radiology Center South Tampa, Tampa, FL 33629-5602 | 2006-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689162612 | Jake Morris | Counselor | 4003 W Morrison Ave, Tampa, FL 33629 | 2018-04-25 |
| 1689192411 | Madalyn Turner | Chiropractor | 3409 W Bay To Bay Blvd Ste B, Tampa, FL 33629 | 2017-08-31 |
| 1063865673 | South Tampa Dental Studio | Dentist | 4306 West Kensington Ave., Tampa, FL 33629 | 2016-07-19 |
| 1093198160 | Mi Ae Kwon | Dentist | 3739 W. Neptune St., Tampa, FL 33629 | 2015-07-07 |
| 1013394568 | Etairos Health, Inc | In Home Supportive Care | 2301 W Palm Ave, Tampa, FL 33629 | 2015-05-05 |
| 1053702589 | Kantilal N. Bhadja, Md | Internal Medicine | 4223 W. El Prado Blvd, Tampa, FL 33629 | 2015-02-05 |
| 1801174016 | Wang & Cortes Dental | Dentist | 1008 South Clearview Avenue, Tampa, FL 33629 | 2011-07-22 |
| 1174826176 | Jada Rae Danielle Traub | Behavioral Analyst | 3271 S. Macdill Ave, Tampa, FL 33629 | 2010-12-13 |
| 1275849846 | Kara Dawson | Physical Therapy Assistant | 3614 South Dale Mabry, Tampa, FL 33629 | 2010-08-20 |
| 1225350580 | Monteleone & Kessler, P.l. | Dentist | 4014 W. Estrella St., Suite B, Tampa, FL 33629 | 2010-02-26 |
| Find all providers in zip 33629 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356953905 | Mayelin Matos | Nurse Practitioner | 8320 W Pocahontas Ave, Tampa, FL 33615-2821 | 2020-08-17 |
| 1184235483 | Kety Uriarte | Nurse Practitioner | 4100 N Tampania Ave, Tampa, FL 33607-6830 | 2020-08-11 |
| 1861001919 | Deborah Diaz Telesford | Nurse Practitioner | 10709 Pleasant Knoll Dr, Tampa, FL 33647-3667 | 2020-07-24 |
| 1699392936 | Medjine Noel | Nurse Practitioner | 7412 French Marigold Ave, Tampa, FL 33619-6941 | 2020-07-02 |
| 1407472129 | Evisencia Mathurin | Nurse Practitioner | 9618 Oak Glade Ave, Tampa, FL 33647-2985 | 2020-06-18 |
| 1811518111 | Ji Universal Medical Group LLC | Nurse Practitioner | 8903 Regents Park Dr Ste 120, Tampa, FL 33647-3083 | 2020-04-28 |
| 1609414135 | Yaima Rodriguez | Nurse Practitioner | 7520 Brookhaven Ct, Tampa, FL 33634-2924 | 2019-12-16 |
| 1366087322 | Sajani Patel | Nurse Practitioner | 5210 Webb Rd Fl 33615, Tampa, FL 33615-4518 | 2019-11-14 |
| 1518501337 | Courtney Anne Sink | Nurse Practitioner | 10515 Villa View Cir, Tampa, FL 33647-2599 | 2019-11-05 |
| 1013472612 | Matthew Bragg | Nurse Practitioner | 13019 Delwood Rd, Tampa, FL 33624-4305 | 2019-02-07 |
| Find all providers in TAMPA | ||||
Please comment or provide details below to improve the information on MR. SHANE BENNETT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.