MEDICARE: DEBORAH M POPOVICH MSN, ARNP, CPNP

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	363L00000X	Nurse Practitioner	1826502	FL
2	363LP0200X	Pediatric Nurse Practitioner	1826502	FL

General Provider Information

NPI Number	:	1619950458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH M POPOVICH MSN, ARNP, CPNP

Provider Business Mailing Address
First Line	:	PO BOX 100197
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32610-0197
Country	:	US
Telephone Number	:	352-273-6342
Fax Number	:	352-273-6585

Provider Business Practice Location Address
First Line	:	101 S. NEWELL DRIVE
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32611
Country	:	US
Telephone Number	:	352-273-6342
Fax Number	:	352-273-6585

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

Provider Enumeration Date	:	11/25/2005
Last Update Date	:	09/11/2025

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