Individual provider Active NPI

Isaiah Antonek

  • Family Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1669870960
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9266788 Issued in FL
Practice address
302 W Fletcher Ave
Tampa, FL 33612-3415
Phone
(813) 397-5300
Fax
(813) 738-9001
NPI assigned
Dec 18, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9266788 FL Primary

Addresses

Primary practice location

302 W Fletcher Ave
Tampa, FL 33612-3415

Mailing address

3700 US Highway 98 N
Lakeland, FL 33809-3861

Other practice location 1

302 W Fletcher Ave
Tampa, FL 33612-3415
Phone (813) 397-5300

Other practice location 2

3700 US Highway 98 N
Lakeland, FL 33809-3861
Phone (863) 815-9523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160509000827 FL Practitioner - Nurse Practitioner 8123327467 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9266788FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa Family Health Centers, Inc CurrentSince Sep 6, 2017 Accepting new patients
Tampa Family Health Centers, Inc CurrentSince Sep 6, 2017 Accepting new patients
Tampa Family Health Centers Inc Current Accepting new patients
MD Now Medical Centers Inc PastSince Nov 1, 2021 Accepting new patients
Dwic of Tampa Bay, Inc Past Accepting new patients

Locations

7814 N Dale Mabry Hwy
Tampa, FL 33614
Phone (813) 405-3939

302 W Fletcher Ave
Tampa, FL 33612

3901 S West Shore Blvd
Tampa, FL 33611
Phone (813) 712-1940

1502 E Fowler Ave
Tampa, FL 33612
Phone (813) 866-0950

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1669870960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 US HIGHWAY 98 N",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338093861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336123415",
            "telephone_number": "813-397-5300",
            "fax_number": "813-738-9001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 W Fletcher Ave",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336123415",
            "country_code": "US",
            "telephone_number": "813-397-5300",
            "fax_number": "813-738-9001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3700 US Highway 98 N",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338093861",
            "country_code": "US",
            "telephone_number": "863-815-9523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANTONEK",
        "first_name": "ISAIAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-18",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9266788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.