Individual provider Active NPI

Ana Paula Marcolina, APRN

  • Gerontology Nurse Practitioner
  • Clermont, FL
National Provider Identifier
1255984175
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11002230 Issued in FL
Practice address
1920 Don Wickham Dr Ste 100
Clermont, FL 34711-1977
Phone
(352) 394-1150
Fax
(352) 394-1560
NPI assigned
Jul 19, 2019
Last updated
Dec 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN11002230 FL Primary

Addresses

Primary practice location

1920 Don Wickham Dr Ste 100
Clermont, FL 34711-1977

Mailing address

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916-2216
Phone (239) 274-8200

Other practice location 1

70 W Gore St Ste 100
Orlando, FL 32806-1124
Phone (407) 426-8484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Feb 12, 2023 Accepting new patients

Locations

1340 N Hancock Rd
Clermont, FL 34711
Phone (352) 394-1150

1920 Don Wickham Dr
Ste 100
Clermont, FL 34711
Phone (352) 394-1150

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916
Phone (239) 432-8500

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1255984175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 VERONICA S SHOEMAKER BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339162216",
            "telephone_number": "239-274-8200",
            "fax_number": "239-278-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 DON WICKHAM DR STE 100",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111977",
            "telephone_number": "352-394-1150",
            "fax_number": "352-394-1560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 W Gore St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061124",
            "country_code": "US",
            "telephone_number": "407-426-8484",
            "fax_number": "407-426-8575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCOLINA",
        "first_name": "ANA",
        "middle_name": "PAULA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2020-12-15",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11002230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.