MARIAH TIENNA PREVATTE APRN
NPI 1750120705
Pediatrics - Pediatric Critical Care Medicine in Lakeland, FL

Q: What is Mariah Prevatte's NPI number?

The NPI number for Mariah Prevatte is 1750120705. It was assigned to this individual provider in the NPPES registry on May 20, 2024.

Q: What is Mariah Prevatte's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.

Q: When was this NPI record last updated?

The NPPES record for Mariah Prevatte was last updated on February 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 20, 2024PECOS Enrolled

1324 LAKELAND HILLS BLVD, LAKELAND, FL 33805(863) 687-1100 Get Directions Write a Review

NPPES record last updated: February 9, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Mariah Tienna Prevatte Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARIAH TIENNA PREVATTE APRN (NPI 1750120705) is an individual pediatric critical care medicine provider in Lakeland, Florida, licensed in Florida (APRN11035770) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS and maintains a secondary practice location in Orlando.

NPPES Registry Identity

NPI1750120705

Entity TypeIndividualFemale

Primary Taxonomy2080P0203X

Provider Legal NameMARIAH TIENNA PREVATTECredential: APRN

Location Address1324 LAKELAND HILLS BLVDLakeland, FL 33805-4543

Mailing Address1850 Saddlewood PlBartow, FL 33830-2917 · (863) 253-9839

Phone(863) 687-1100

Sole ProprietorNo

Enumeration DateMay 20, 2024

Last NPPES UpdateFebruary 9, 2025

NPPES CertifiedFebruary 9, 2025

✔ NPI 1750120705 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric Critical Care MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0203X

License✔ Licensed in FL · APRN11035770

Definition

A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists.

Also ListedRegistered Nurse · PediatricsTaxonomy 163WP0200X · License RN9423564 (FL)

1324 LAKELAND HILLS BLVD, Lakeland, FL 33805

Open in Google Maps ↗

Secondary Practice Location 1

Location 16535 Nemours PkwyOrlando, FL 32827-7884 · Phone (407) 650-7715

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mariah Tienna Prevatte Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHRISTIAN ABREU-RAMIREZ MD

Internal Medicine (Pulmonary Disease)