Provider Demographics
NPI:1538729710
Name:IPOCK, DENNIS MICHAEL (APRN)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:MICHAEL
Last Name:IPOCK
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:MR
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:IPOCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:2236 GREEN HEDGES WAY
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-8189
Mailing Address - Country:US
Mailing Address - Phone:813-999-0505
Mailing Address - Fax:813-701-9450
Practice Address - Street 1:2236 GREEN HEDGES WAY
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-8189
Practice Address - Country:US
Practice Address - Phone:813-999-0505
Practice Address - Fax:813-701-9450
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11002826363L00000X, 363LP2300X
FLAPRN11002826207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care