Basic Information
| Provider Information | |||||||||
| NPI: | 1447325659 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAEPKE | ||||||||
| FirstName: | JOANNA | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7400 DOCS GROVE CIR | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328198010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073529717 | ||||||||
| FaxNumber: | 4073545425 | ||||||||
| Practice Location | |||||||||
| Address1: | 7400 DOCS GROVE CIR | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328198010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073529717 | ||||||||
| FaxNumber: | 4073545425 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2006 | ||||||||
| LastUpdateDate: | 02/15/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA 9102657 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.