Provider Demographics
NPI:1013933787
Name:PRESTON, DAVID BRYAN SR (DC, ARNP)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRYAN
Last Name:PRESTON
Suffix:SR
Gender:M
Credentials:DC, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 1ST AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8407
Mailing Address - Country:US
Mailing Address - Phone:727-327-4522
Mailing Address - Fax:727-327-8069
Practice Address - Street 1:3600 1ST AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8407
Practice Address - Country:US
Practice Address - Phone:727-327-4522
Practice Address - Fax:727-327-8069
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005153111N00000X
FLARNP9322426363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
70759OtherMEDICARE
FLARNP9322426OtherFLORIDA LICENSE
FLCH0005153OtherFLORIDA LICENSE NUMBER
FL050430101Medicaid
FL050430101Medicaid