Provider Demographics
NPI:1548583677
Name:TROYER, JOETTA LEIGH (PA-C, MCMSC)
Entity Type:Individual
Prefix:
First Name:JOETTA
Middle Name:LEIGH
Last Name:TROYER
Suffix:
Gender:F
Credentials:PA-C, MCMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7656
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34278-7656
Mailing Address - Country:US
Mailing Address - Phone:941-320-4602
Mailing Address - Fax:941-371-7502
Practice Address - Street 1:902 DEER HAMMOCK RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-5803
Practice Address - Country:US
Practice Address - Phone:941-320-4602
Practice Address - Fax:941-371-7502
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105330363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant