MEDICARE: DEBORAH VOUTOUR ARNP

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	363LP2300X	Primary Care Nurse Practitioner	ARNP2166022	FL
2	363L00000X	Nurse Practitioner	APRN2166022	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ARNP2166022	OTHER	FL	LICENSE NUMBER
2	QG164	OTHER	FL	HF MA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508890674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH VOUTOUR ARNP

Provider Business Mailing Address
First Line	:	5717 21ST AVE WEST
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5717 21ST AVE WEST
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34209-3420
Country	:	US
Telephone Number	:	941-792-8383
Fax Number	:	941-792-8484

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	02/21/2023

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