Individual provider Active NPI

Tara Marie Ice, NNP

  • Neonatal Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1356207930
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
11045463 Issued in FL
Practice address
3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307
Phone
(813) 872-2929
NPI assigned
Dec 29, 2025
Last updated
May 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 11045463 FL Primary

Addresses

Primary practice location

3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307

Mailing address

1301 Concord Ter
Sunrise, FL 33323-2843
Phone (954) 692-7615

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11045463FLMDNeonatal Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1766966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1356207930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 CONCORD TER",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232843",
            "telephone_number": "954-692-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 W DR MARTIN LUTHER KING JR BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076307",
            "telephone_number": "813-872-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICE",
        "first_name": "TARA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-29",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "FL",
            "license": "11045463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; 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.