=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619133253
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALBERT PAUL WILLISON ARNP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/04/2008
-----------------------------------------------------
Last Update Date | 04/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3320 SW 33RD RD STE 200
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34474-7427
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 520-395-0512
-----------------------------------------------------
Fax | 520-505-4108
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3320 SW 33RD RD STE 200
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34474-7427
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-512-0970
-----------------------------------------------------
Fax | 352-512-0962
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | ARNP2910702
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LG0600X
-----------------------------------------------------
Taxonomy Name | Gerontology Nurse Practitioner
-----------------------------------------------------
License Number | ARNP2910702
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------