Healthcare Provider Details

I. General information

NPI: 1427020619
Provider Name (Legal Business Name): STEVEN POWELL, MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 12/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 SE 3RD CT SUITE A
OCALA FL
34471-0485
US

IV. Provider business mailing address

2910 SE 3RD CT
OCALA FL
34471-0485
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-0339
  • Fax: 352-732-3715
Mailing address:
  • Phone: 352-732-0339
  • Fax: 352-732-3715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME46230
License Number StateFL

VIII. Authorized Official

Name: DR. STEVEN POWELL
Title or Position: PHYSICIAN
Credential: MD
Phone: 352-732-0339