Healthcare Provider Details

I. General information

NPI: 1144284811
Provider Name (Legal Business Name): MARK J POWERS MD PA FLORIDA ORTHOPAEDIC SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 03/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9077 S FEDERAL HWY
PORT ST LUCIE FL
34952-3405
US

IV. Provider business mailing address

9077 S FEDERAL HWY
PORT ST LUCIE FL
34952-3405
US

V. Phone/Fax

Practice location:
  • Phone: 772-335-4770
  • Fax: 772-335-4133
Mailing address:
  • Phone: 772-335-4770
  • Fax: 772-335-4133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK J. POWERS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 772-335-4770