Healthcare Provider Details

I. General information

NPI: 1316873003
Provider Name (Legal Business Name): DEAN JABER APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4480 51ST ST W
BRADENTON FL
34210-2855
US

IV. Provider business mailing address

4480 51ST ST W
BRADENTON FL
34210-2855
US

V. Phone/Fax

Practice location:
  • Phone: 941-251-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11048005
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: