Healthcare Provider Details

I. General information

NPI: 1376138651
Provider Name (Legal Business Name): BECKY AKONWAH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2021
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 E FLETCHER AVE
TAMPA FL
33637-0916
US

IV. Provider business mailing address

31029 BACLAN DR
WESLEY CHAPEL FL
33545-8271
US

V. Phone/Fax

Practice location:
  • Phone: 813-490-6205
  • Fax:
Mailing address:
  • Phone: 813-484-0261
  • Fax: 813-973-1422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN11011250
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: