Provider Demographics
NPI:1497400618
Name:DYMEK, JEFFREY MICHAEL (MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:MICHAEL
Last Name:DYMEK
Suffix:
Gender:M
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3914 E STATE ROAD 64
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-9059
Mailing Address - Country:US
Mailing Address - Phone:941-756-1200
Mailing Address - Fax:941-739-9358
Practice Address - Street 1:3914 E STATE ROAD 64
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-9059
Practice Address - Country:US
Practice Address - Phone:941-756-1200
Practice Address - Fax:941-739-9358
Is Sole Proprietor?:No
Enumeration Date:2022-02-16
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11018237363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health