Provider Demographics
NPI:1871248203
Name:SOARES, JOY ANN (APRN)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:ANN
Last Name:SOARES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5803 LEGACY CRESCENT PL UNIT 301
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-3885
Mailing Address - Country:US
Mailing Address - Phone:813-545-8829
Mailing Address - Fax:
Practice Address - Street 1:311 NOLAND DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5719
Practice Address - Country:US
Practice Address - Phone:813-654-8100
Practice Address - Fax:813-874-0099
Is Sole Proprietor?:No
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11013924363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner