Provencher, David E.

Provencher, David E. is an sole proprietor health care provider with primary practice located at 106 Southern Oak Drive , Plant City FL 33563. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology, Allopathic & Osteopathic Physicians / Allergy & Immunology. Allopathic & Osteopathic Physicians / Allergy & Immunology is his primary health care specialty. Provencher, David E. can be contacted via phone (813) 752-8595.

Contact Information

Primary practice address
106 Southern Oak Drive Plant City FL 33563
Fax: (813) 752-8088
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Allergy/Immunology 2080P0201X ME81615 Florida
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X ME81615 Florida

Profile Details

NPI number 1326098120
LBN Legal business name Provencher, David E.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 11th, 2006
Last updated Jan 16th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326098120 NPPES
Florida MEDICAID 262145201

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