Basic Information
| Provider Information | |||||||||
| NPI: | 1497175921 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOWARD | ||||||||
| FirstName: | BEVERLEY | ||||||||
| MiddleName: | YVETTE | ||||||||
| NamePrefix: | MS. | ||||||||
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| OtherOrganizationName: | |||||||||
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| OtherLastName: | HOWARD | ||||||||
| OtherFirstName: | BEVERLEY | ||||||||
| OtherMiddleName: | YVETTE | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | ARNP | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 10250 SE 167TH PLACE RD | ||||||||
| Address2: | STE 5-3 | ||||||||
| City: | SUMMERFIELD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344918686 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076976177 | ||||||||
| FaxNumber: | 8634276590 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 N DEAN RD | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328253710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073847388 | ||||||||
| FaxNumber: | 4073847391 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2014 | ||||||||
| LastUpdateDate: | 05/16/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 3003062 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.