Provider Demographics
NPI:1790541258
Name:BECKER, JOEL (APRN)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:
Last Name:BECKER
Suffix:
Gender:M
Credentials:APRN
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 100129
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0129
Mailing Address - Country:US
Mailing Address - Phone:352-265-5470
Mailing Address - Fax:352-627-4173
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-1134
Practice Address - Country:US
Practice Address - Phone:352-265-5470
Practice Address - Fax:352-627-4173
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11031391363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care