1265736912 NPI number — JOY DREXLER A.R.N.P

Table of content: JOY DREXLER A.R.N.P (NPI 1265736912)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265736912 NPI number — JOY DREXLER A.R.N.P

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DREXLER
Provider First Name:
JOY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
A.R.N.P
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265736912
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15320 AMBERLY DR
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33647-1647
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-977-0733
Provider Business Mailing Address Fax Number:
813-971-2230

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20615 AMBERFIELD DR
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
LAND O LAKES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34638-4387
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-949-2950
Provider Business Practice Location Address Fax Number:
813-949-2924
Provider Enumeration Date:
01/10/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  ARNP9192355 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: ARNP9192355 . This is a "STATE LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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