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General NPI Number Information
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NPI Number | 1912596677
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Entity Type | Individual
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Provider Name | MICHELLE AILEEN POWERS
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Gender | Female
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Dates
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Enumeration Date | 01/15/2021
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Last Update Date | 01/15/2021
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Provider Practice Location Address
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Address Line | 277 W SR 436
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-4228
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Country | US
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Telephone | 407-389-6025
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Fax |
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Provider Business Mailing Address
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Address Line | 1797 SENECA BLVD
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-5619
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Country | US
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Telephone | 740-398-2808
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS60010
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03-320187
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS6010
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License Number State | FL
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