MS. BEVERLY SUZANNE JUCKNATH


Address: 3003 W Dr Martin Luther King Jr Blvd Fl 2, Tampa, FL 33607-6307
Phone: 8133216580

MS. BEVERLY SUZANNE JUCKNATH (NPI# 1235693268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1235693268
Entity Type Individual
Full Name MS. BEVERLY SUZANNE JUCKNATH
Credential APRN-C
Practice Address 3003 W Dr Martin Luther King Jr Blvd Fl 2
Tampa
FL 33607-6307
Mailing Address 2995 Drew St Fl 2
Clearwater
FL 33759-3012
Practice Telephone 8133216580
Practice Fax Number 8134438185
Mailing Telephone 7275321355
Mailing Fax Number 8136352613
Enumeration Date 2019-01-23
Last Update Date 2020-06-09
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163WC0200X Registered Nurse
Specialization: Critical Care Medicine
RN9361508 FL Nursing Service Providers
Y 363L00000X Nurse Practitioner APRN11003292 FL Physician Assistants & Advanced Practice Nursing Providers
N 363LA2200X Nurse Practitioner
Specialization: Adult Health
APRN11003292 FL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
FL 106459800 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
777 N Ashley Dr Unit 3211, Tampa, FL 336024387 4074966187

Office Location

Street Address 3003 W DR MARTIN LUTHER KING JR BLVD FL 2
City TAMPA
State FL
Zip Code 33607-6307

Providers in the same location

NPI Name Taxonomy Address Enumeration
1194761973 Jonathan Waxman Thoracic Surgery (Cardiothoracic Vascular Surgery) 3003 W Dr Martin Luther King Jr Blvd Fl 2, Tampa, FL 33607-6307 2006-06-21
1265930267 Mackenzie Donigan Saadeh Physician Assistant 3003 W Dr Martin Luther King Jr Blvd Fl 2, Tampa, FL 33607-6307 2018-01-25
1841701125 Zoe Rose Quinn-kelly Physician Assistant 3003 W Dr Martin Luther King Jr Blvd Fl 2, Tampa, FL 33607-6307 2017-10-13
1659892651 Bari Murtuza Thoracic Surgery (Cardiothoracic Vascular Surgery) 3003 W Dr Martin Luther King Jr Blvd Fl 2, Tampa, FL 33607-6307 2017-06-29
1912459249 David A Wiles Nurse Practitioner 3003 W Dr Martin Luther King Jr Blvd Fl 2, Tampa, FL 33607-6307 2016-11-03
1720537921 Paolo Calizo Physician Assistant 3003 W Dr Martin Luther King Jr Blvd Fl 2, Tampa, FL 33607 2016-09-28
1366815870 Angela P Laube Physician Assistant 3003 W Dr Martin Luther King Jr Blvd Fl 2, Tampa, FL 33607-6307 2015-11-05
1275891913 John P Schmittner Internal Medicine 3003 W Dr Martin Luther King Jr Blvd Fl 2, Tampa, FL 33607-6307 2012-05-01
1407090723 Phillips Brewster Harrington Surgery 3003 W Dr Martin Luther King Jr Blvd Fl 2, Tampa, FL 33607 2009-04-30
1982866133 Alexis R Powell Surgery 3003 W Dr Martin Luther King Jr Blvd Fl 2, Tampa, FL 33607 2008-06-30
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1326656265 Sky City Pharmacy LLC Pharmacy 2812 W. Dr Martin Luther King Jr Blvd, Tampa, FL 33607 2020-07-16
1821614413 Tammy Sue Alleyn Social Worker 4414 N. Armenia Av., Tampa, FL 33607 2020-06-19
1912528290 Advanced Mobile Medical Services Clinic/Center 2136 W. Mlk Blvd, Tampa, FL 33607 2020-04-28
1659909232 Rachel Sobiech Social Worker 2006 Pan Am Circle, Suite 270, Tampa, FL 33607 2020-03-30
1295379733 Melizza Liz Sanchez Ayala Registered Nurse 1701 N Lois Avenue, Valera Apt Unit 224, Tampa, FL 33607 2019-10-28
1720647191 Caretyme LLC Clinic/Center 1923 West St. John Street, Tampa, FL 33607 2019-06-10
1720545981 Amante Medical and Diabetic Center, P.a. Internal Medicine 1001 N Macdill Ave. Suite B, Tampa, FL 33607 2019-02-25
1609360908 Misty Dawn Ray Ross Social Worker 2902 N Armenia Ave Ste 200, Tampa, FL 33607 2018-06-20
1255825154 Kenneth Konrad Schirer Physical Therapist 2700 W Dr. Mlk Blvd, Suite 300, Tampa, FL 33607 2018-06-14
1902314875 Cardiac Cin of Florida, LLC Internal Medicine 3001 W Martin Luther King Jr Blvd, Tampa, FL 33607 2018-01-13
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(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.

Providers in the same taxonomy and city

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
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Competitor

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City TAMPA
Zip Code 33607

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Dataset Information

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.

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