Provider Demographics
NPI:1598933830
Name:RODELL, FRANK J (ARNP)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:J
Last Name:RODELL
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 94TH AVE N STE 305
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-2452
Mailing Address - Country:US
Mailing Address - Phone:727-565-0308
Mailing Address - Fax:727-851-9119
Practice Address - Street 1:710 94TH AVE N STE 305
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-2452
Practice Address - Country:US
Practice Address - Phone:727-565-0308
Practice Address - Fax:727-851-9119
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2022-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP3627363LP0808X
IL209015485363LP0808X
WI3881-33363LP0808X
WAAP60759980363LP0808X
FLAPRN11013794363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
12032003OtherCAQH
WI008770104Medicare Oscar/Certification
WIP00962540Medicare Oscar/Certification