MEDICARE: MRS. AIDA Y POWE RN

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	163W00000X	Registered Nurse	9455484	FL

General Provider Information

NPI Number	:	1518777366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AIDA Y POWE RN

Provider Business Mailing Address
First Line	:	3265 VICTORIA CT E
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-5625
Country	:	US
Telephone Number	:	904-714-5699
Fax Number	:

Provider Business Practice Location Address
First Line	:	503 LOWER 8TH AVE S
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-5255
Country	:	US
Telephone Number	:	904-714-5699
Fax Number	:

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

Provider Enumeration Date	:	01/13/2025
Last Update Date	:	01/13/2025

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