Individual
DEVORA DIONNE FEDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(813) 745-4673
Mailing address
PO BOX 198441, ATLANTA, GA 30384-8441
(813) 745-4673
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
APRN11017806
FL
363LP2300X
Primary Care Nurse Practitioner
ARNP9411595
FL
Other
Enumeration date
07/19/2018
Last updated
04/21/2026
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