MEDICARE: MARCIA A. HOWELL

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	315P00000X	Intellectual Disabilities Intermediate Care Facility
2	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245404250
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARCIA A. HOWELL

Provider Business Mailing Address
First Line	:	PO BOX 321
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-0321
Country	:	US
Telephone Number	:	813-505-0454
Fax Number	:	813-926-4304

Provider Business Practice Location Address
First Line	:	17305 BLOOMING FIELDS DR
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-7222
Country	:	US
Telephone Number	:	813-505-0454
Fax Number	:	813-926-4304

Authorized Official
Title or Position	:	OWNER
Name	:	MS. MARCIA A HOWELL
Credential	:
Telephone Number	:	813-505-0454

Provider Enumeration Date	:	04/22/2008
Last Update Date	:	06/24/2008

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