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NPI Code Detail

MEDICARE: PIUS N GODWIN ARNP

MEDICARE: PIUS N GODWIN 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
1363L00000XNurse PractitionerARNP1921112FL
2363LG0600XGerontology Nurse PractitionerR78479FL

General Provider Information

NPI Number : 1831187012
Entity Type Code : Individual
Provider Name (Legal Business Name) : PIUS N GODWIN ARNP
Provider Business Mailing Address
First Line : 117 W ALEXANDER ST STE 387
Second Line :
City : PLANT CITY
State : FL
Zip : 33563-7155
Country : US
Telephone Number : 813-754-7756
Fax Number :
Provider Business Practice Location Address
First Line : 1267 TIMBERIDGE LOOP N
Second Line :
City : LAKELAND
State : FL
Zip : 33809-4682
Country : US
Telephone Number : 863-602-7908
Fax Number : 863-815-1901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2005
Last Update Date : 08/01/2008

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