Provider Demographics
NPI:1700026184
Name:LOSADA, JESSICA B (ARNP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:B
Last Name:LOSADA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:I
Other - Last Name:BUSCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:602 VONDERBURG DR STE 103
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5900
Mailing Address - Country:US
Mailing Address - Phone:813-720-8001
Mailing Address - Fax:813-445-8168
Practice Address - Street 1:602 VONDERBURG DR STE 103
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511
Practice Address - Country:US
Practice Address - Phone:727-456-3288
Practice Address - Fax:727-456-3289
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9266376363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000659800Medicaid