Provider Demographics
NPI:1659857555
Name:YOUTZ, DANE J (ARNP)
Entity Type:Individual
Prefix:
First Name:DANE
Middle Name:J
Last Name:YOUTZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:442 W KENNEDY BLVD STE 280
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-1464
Mailing Address - Country:US
Mailing Address - Phone:813-467-6111
Mailing Address - Fax:813-906-1755
Practice Address - Street 1:5510 N HESPERIDES ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-5414
Practice Address - Country:US
Practice Address - Phone:813-467-6111
Practice Address - Fax:813-906-1755
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHRN.414914163WC0200X
OHAPRN.CNP.023064363LF0000X
FLAPRN11010471363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily