MEDICARE: FRANK DAVID FIDLER ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	RN9168596	FL
2	363LF0000X	Family Nurse Practitioner	APRN9168596	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F0404110	OTHER	FL	AMERICAN ACADEMY OF NURSE PRACTITIONERS

General Provider Information

NPI Number	:	1508968488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANK DAVID FIDLER ARNP

Provider Business Mailing Address
First Line	:	3030 NORTH ROCKY POINT DRIVE WEST
Second Line	:	SUITE 670
City	:	TAMPA
State	:	FL
Zip	:	33607-5906
Country	:	US
Telephone Number	:	813-289-6597
Fax Number	:	813-289-6592

Provider Business Practice Location Address
First Line	:	3030 NORTH ROCKY POINT DRIVE WEST
Second Line	:	SUITE 670
City	:	TAMPA
State	:	FL
Zip	:	33607-5906
Country	:	US
Telephone Number	:	813-289-6597
Fax Number	:	813-289-6592

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	10/27/2022

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Directions to “ FRANK DAVID FIDLER ARNP” Practice Location

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