Healthcare Provider Details

I. General information

NPI: 1417005679
Provider Name (Legal Business Name): JILL BENNETT DRACHLER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2007
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 FRUITVILLE RD
SARASOTA FL
34237-6223
US

IV. Provider business mailing address

711 39TH ST W
BRADENTON FL
34205-2453
US

V. Phone/Fax

Practice location:
  • Phone: 941-365-0333
  • Fax:
Mailing address:
  • Phone: 941-748-0740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP1741732
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: