MEDICARE: DAVID POWELL NP

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	363LF0000X	Family Nurse Practitioner	ARNP1039062	FL

General Provider Information

NPI Number	:	1821088832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID POWELL NP

Provider Business Mailing Address
First Line	:	14359 MIRAMAR PKWY
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-4134
Country	:	US
Telephone Number	:	954-435-3940
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 W 68TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-1801
Country	:	US
Telephone Number	:	305-364-2124
Fax Number	:

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	03/07/2008

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