Provider Demographics
NPI:1396268967
Name:MARKOWITZ, ASHLEIGH NICOLE (PA-C)
Entity type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:NICOLE
Last Name:MARKOWITZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 E FLETCHER AVE STE 126
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4613
Mailing Address - Country:US
Mailing Address - Phone:813-467-4252
Mailing Address - Fax:813-467-4251
Practice Address - Street 1:3100 E FLETCHER AVE STE 126
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4613
Practice Address - Country:US
Practice Address - Phone:813-467-4252
Practice Address - Fax:813-467-4251
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9110544363A00000X
FL9110544363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022136300Medicaid