Provider Demographics
NPI:1902134208
Name:BALES, ISABEL (APRN-C)
Entity Type:Individual
Prefix:MRS
First Name:ISABEL
Middle Name:
Last Name:BALES
Suffix:
Gender:F
Credentials:APRN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3003 W DR MARTIN LUTHER KING JR BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6307
Mailing Address - Country:US
Mailing Address - Phone:813-870-4421
Mailing Address - Fax:813-870-4390
Practice Address - Street 1:3001 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6307
Practice Address - Country:US
Practice Address - Phone:813-870-4421
Practice Address - Fax:813-870-4390
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007905363L00000X
FLAPRN9360051363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009174600Medicaid
FLP01283840OtherRAILROAD MEDICARE
FLAPRN9360051OtherFLORIDA LICENSE
FLY0HJ3OtherBCBS
FLY0HJ3OtherBCBS