MEDICARE: AVRA HELENA CARPOUSIS-BOWERS MD

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	207R00000X	Internal Medicine Physician	ME0086544	FL

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	:	1851389407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AVRA HELENA CARPOUSIS-BOWERS MD

Provider Business Mailing Address
First Line	:	4211 NW 13TH ST
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33993-9116
Country	:	US
Telephone Number	:	239-424-1449
Fax Number	:	239-424-1421

Provider Business Practice Location Address
First Line	:	4771 S CLEVELAND AVE
Second Line	:
City	:	FT MYERS
State	:	FL
Zip	:	33907-1317
Country	:	US
Telephone Number	:	239-274-7100
Fax Number	:

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

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	02/28/2017

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