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General NPI Number Information
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NPI Number | 1962109835
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Entity Type | Individual
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Provider Name | MATTHEW ANTHONY BEDOSKY DNP, APRN, FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 02/13/2023
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 11125 PARK BLVD STE 118
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City | SEMINOLE
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State | FL
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Zip | 33772-4700
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Country | US
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Telephone | 813-294-6024
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Fax |
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Provider Business Mailing Address
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Address Line | 412 7TH AVE N
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City | TIERRA VERDE
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State | FL
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Zip | 33715-1819
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Country | US
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Telephone | 813-294-6024
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11024433
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License Number State | FL
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