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NPI Code Detail

MEDICARE: MR. RICHARD TODD OWENS ARNP

MEDICARE: MR. RICHARD TODD OWENS ARNP
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
1363L00000XNurse PractitionerAPRN2522672FL
2363LF0000XFamily Nurse PractitionerARNP2522672FL

General Provider Information

NPI Number : 1639330467
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RICHARD TODD OWENS ARNP
Provider Business Mailing Address
First Line : PO BOX 100237
Second Line :
City : GAINESVILLE
State : FL
Zip : 32610-0237
Country : US
Telephone Number : 352-392-4541
Fax Number : 352-294-8519
Provider Business Practice Location Address
First Line : 110 HEALTH PARK BLVD
Second Line :
City : SAINT AUGUSTINE
State : FL
Zip : 32086-5776
Country : US
Telephone Number : 904-823-3401
Fax Number : 904-829-8649
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2008
Last Update Date : 04/18/2025

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