Provider Demographics
NPI:1538118260
Name:TECCA, JOYCE E (ARNP)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:E
Last Name:TECCA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 W PINELOCH AVE.
Mailing Address - Street 2:STE. 23
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-6100
Mailing Address - Country:US
Mailing Address - Phone:866-674-7277
Mailing Address - Fax:407-852-2782
Practice Address - Street 1:102 W PINELOCH AVE.
Practice Address - Street 2:STE. 23
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-6100
Practice Address - Country:US
Practice Address - Phone:866-674-7277
Practice Address - Fax:407-852-2782
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1729742363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306698300Medicaid
FL306698300Medicaid
FLY7318SMedicare PIN
FLS77560Medicare UPIN