Healthcare Provider Details

I. General information

NPI: 1467371336
Provider Name (Legal Business Name): ASHLEY ARTIS NRCMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 S PARSONS AVE
BRANDON FL
33511-6063
US

IV. Provider business mailing address

811 S PARSONS AVE
BRANDON FL
33511-6063
US

V. Phone/Fax

Practice location:
  • Phone: 813-685-4553
  • Fax:
Mailing address:
  • Phone: 813-685-4553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number121530
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: