Provider Demographics
NPI:1750266748
Name:POP, TABITA ANA
Entity type:Individual
Prefix:
First Name:TABITA
Middle Name:ANA
Last Name:POP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 13TH ST SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34117-2108
Mailing Address - Country:US
Mailing Address - Phone:239-216-1101
Mailing Address - Fax:
Practice Address - Street 1:481 13TH ST SW
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34117-2108
Practice Address - Country:US
Practice Address - Phone:239-216-1101
Practice Address - Fax:239-317-6821
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11041422363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty