MEDICARE: DR. VICTOR NICK HOWARD M.D.

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	174400000X	Specialist	ME53389	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME53389	OTHER	FL	MEDICAL LICENSE

General Provider Information

NPI Number	:	1114961737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTOR NICK HOWARD M.D.

Provider Business Mailing Address
First Line	:	4161 TAMIAMI TRL
Second Line	:	SUITE 802
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-9204
Country	:	US
Telephone Number	:	941-625-6223
Fax Number	:	941-627-2680

Provider Business Practice Location Address
First Line	:	4161 TAMIAMI TRL
Second Line	:	SUITE 802
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-9204
Country	:	US
Telephone Number	:	941-625-6223
Fax Number	:	941-627-2680

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	05/11/2011

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