MEDICARE: JOYCE A PARKS 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	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	ARNP1196942	FL

General Provider Information

NPI Number	:	1982684791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOYCE A PARKS ARNP

Provider Business Mailing Address
First Line	:	PO BOX 1014
Second Line	:
City	:	ELFERS
State	:	FL
Zip	:	34680-1014
Country	:	US
Telephone Number	:	727-849-2005
Fax Number	:	727-849-2087

Provider Business Practice Location Address
First Line	:	4821 US HIGHWAY 19 STE 1
Second Line	:
City	:	NEW PRT RCHY
State	:	FL
Zip	:	34652-4259
Country	:	US
Telephone Number	:	727-849-2005
Fax Number	:	727-849-2087

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

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	07/02/2013

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