Healthcare Provider Details

I. General information

NPI: 1467630798
Provider Name (Legal Business Name): ERIN V. OWOC ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10640 GRIFFIN RD STE 102
DAVIE FL
33328-3214
US

IV. Provider business mailing address

11945 SW 15TH CT
DAVIE FL
33325-4633
US

V. Phone/Fax

Practice location:
  • Phone: 954-680-8330
  • Fax: 954-436-0115
Mailing address:
  • Phone: 954-249-8188
  • Fax: 954-827-4676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP3199092
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: