Healthcare Provider Details

I. General information

NPI: 1063654242
Provider Name (Legal Business Name): DOROTHEA DREW FRUM ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DOROTHEA LYNETTE LEVER

II. Dates (important events)

Enumeration Date: 04/02/2009
Last Update Date: 11/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD #100371
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

1600 SW ARCHER RD BOX 100109
GAINESVILLE FL
32610-0109
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-5670
  • Fax: 352-273-5683
Mailing address:
  • Phone: 352-265-1060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP2051822
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: