Individual
MINDY OBERLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2010 59TH ST W STE 2200, BRADENTON, FL 34209-4689
(941) 794-5621
Mailing address
930 CENTRAL AVE UNIT 501, ST PETERSBURG, FL 33705-1671
(262) 501-2006
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4727-23
WI
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4727-23
STATE LICENSE
WI
Enumeration date
06/26/2019
Last updated
10/18/2024
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