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
Phone: (813) 752-8595
Fax: (813) 752-8088
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326098120 | NPPES |
| Florida | MEDICAID | 262145201 |
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