MEDICARE: WILLIAM J LOVE PA

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	363AM0700X	Medical Physician Assistant	PA9102752	FL

General Provider Information

NPI Number	:	1427084565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM J LOVE PA

Provider Business Mailing Address
First Line	:	2999 NE 191ST ST STE 406
Second Line	:
City	:	AVENTURA
State	:	FL
Zip	:	33180-3116
Country	:	US
Telephone Number	:	305-692-9009
Fax Number	:

Provider Business Practice Location Address
First Line	:	2999 NE 191ST ST STE 406
Second Line	:
City	:	AVENTURA
State	:	FL
Zip	:	33180-3116
Country	:	US
Telephone Number	:	305-692-9009
Fax Number	:

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	11/04/2013

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Directions to “ WILLIAM J LOVE PA” Practice Location

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