Healthcare Provider Details

I. General information

NPI: 1073201471
Provider Name (Legal Business Name): EMPOWERED FLOWER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 NW 68TH AVE APT 406
PLANTATION FL
33317-7596
US

IV. Provider business mailing address

404 NW 68TH AVE APT 406
PLANTATION FL
33317-7596
US

V. Phone/Fax

Practice location:
  • Phone: 561-299-0773
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DAPHENY M CARTER
Title or Position: OWNER
Credential: APRN, FNP/BC
Phone: 561-299-0773