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General NPI Number Information
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NPI Number | 1447228614
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Entity Type | Individual
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Provider Name | FRED I HOWARD III MD
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Gender | Male
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 09/26/2019
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Provider Practice Location Address
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Address Line | 451 S 11TH ST
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City | LAKE WALES
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State | FL
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Zip | 33853
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Country | US
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Telephone | 863-679-1986
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Fax | 863-676-3126
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Provider Business Mailing Address
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Address Line | 451 S 11TH ST
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City | LAKE WALES
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State | FL
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Zip | 33853-4251
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Country | US
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Telephone | 863-679-1986
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Fax | 863-676-3126
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME82331
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License Number State | FL
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