Healthcare Provider Details

I. General information

NPI: 1710693502
Provider Name (Legal Business Name): BECKY O ASARE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2023
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14502 N DALE MABRY HWY STE 200
TAMPA FL
33618-2040
US

IV. Provider business mailing address

PO BOX 1200
PLEASANT GROVE UT
84062-1200
US

V. Phone/Fax

Practice location:
  • Phone: 800-640-3451
  • Fax:
Mailing address:
  • Phone: 800-640-3451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11022827
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: