MEDICARE: REBECA ELIZABETH POWER DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DN16817	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144464603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECA ELIZABETH POWER DMD

Provider Business Mailing Address
First Line	:	900 E OCEAN BLVD STE 216B
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34994-3501
Country	:	US
Telephone Number	:	772-223-1539
Fax Number	:	772-223-4545

Provider Business Practice Location Address
First Line	:	3251 NW FEDERAL HWY
Second Line	:
City	:	JENSEN BEACH
State	:	FL
Zip	:	34957-4457
Country	:	US
Telephone Number	:	772-692-1447
Fax Number	:	772-692-3551

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2009
Last Update Date	:	04/28/2009

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