Provider Demographics
NPI:1508968488
Name:FIDLER, FRANK DAVID (ARNP)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:DAVID
Last Name:FIDLER
Suffix:
Gender:M
Credentials:ARNP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3030 NORTH ROCKY POINT DRIVE WEST
Mailing Address - Street 2:SUITE 670
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-5906
Mailing Address - Country:US
Mailing Address - Phone:813-289-6597
Mailing Address - Fax:813-289-6592
Practice Address - Street 1:3030 NORTH ROCKY POINT DRIVE WEST
Practice Address - Street 2:SUITE 670
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5906
Practice Address - Country:US
Practice Address - Phone:813-289-6597
Practice Address - Fax:813-289-6592
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLRN9168596207R00000X
FLAPRN9168596363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF0404110OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS