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NPI Code Detail

MEDICARE: NICOLE A COWETTE C-PA

MEDICARE: NICOLE A COWETTE C-PA
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
1363AM0700XMedical Physician AssistantPA9102638FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1U2463VOTHERFLMEDICARE P-TAN

General Provider Information

NPI Number : 1659361988
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE A COWETTE C-PA
Provider Business Mailing Address
First Line : 1600 37TH ST
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-4863
Country : US
Telephone Number : 772-766-0789
Fax Number : 772-581-3991
Provider Business Practice Location Address
First Line : 1600 37TH ST
Second Line :
City : VERO BEACH
State : FL
Zip : 32960-4863
Country : US
Telephone Number : 772-766-0789
Fax Number : 772-581-3991
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2005
Last Update Date : 05/29/2014

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Directions to “ NICOLE A COWETTE C-PA” Practice Location

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