MEDICARE: ROWAN STEPHEN FUNES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN9383170	FL

General Provider Information

NPI Number	:	1033526983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROWAN STEPHEN FUNES

Provider Business Mailing Address
First Line	:	1705 BARKER ST NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32907-2480
Country	:	US
Telephone Number	:	808-281-1562
Fax Number	:

Provider Business Practice Location Address
First Line	:	1705 BARKER ST NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32907-2480
Country	:	US
Telephone Number	:	808-281-1562
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2014
Last Update Date	:	07/11/2014

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Directions to “ ROWAN STEPHEN FUNES ” Practice Location

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