Male or Other

Douglas Tidwell MSN, ARNP, FNP-C

Family Nurse Practitioner in Sarasota, FL(View on Map)

Full Name

Douglas Tidwell MSN, ARNP, FNP-C

NPI Number

1689079337

NPI Type

Individual Provider

Gender

Male

Enumeration Date

10/23/2014

Specialties

(Taxonomies)

Code

363LF0000X

Primary Taxonomy

Yes

Licenses

State

Florida
Florida

License Number

9326689
APRN9326689

Contact
Information

Purpose

Mailing
Location

Address

4435 SPAHN ST
5955 RAND BLVD

City

Sarasota
Sarasota

State

FL
FL

Postal Code

34232-5135
34238-5160

Country

US
US

Telephone Number

(941) 726-2082
(941) 552-7508

Identifiers

Identifier

IB924Z

Identifier State

FL

Identifier Issuer

MEDICARE

Health Information Exchange

Endpoint Type

CONNECT

Endpoint

Email

Endpoint Description

Unknown

Use

Direct

Content Type

CSV

Affiliation

N

Endpoint Location

5955 Rand BlvdSarasota, FL342385160US

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 11/20/2019

Provider Address

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