Provider Demographics
NPI:1093731523
Name:POWERS, ARIEL (PA-C)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:POWERS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 VILLAGE SQUARE XING STE 290
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4552
Mailing Address - Country:US
Mailing Address - Phone:904-404-8555
Mailing Address - Fax:904-517-1619
Practice Address - Street 1:4776 HODGES BLVD STE 105
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-7218
Practice Address - Country:US
Practice Address - Phone:044-048-5559
Practice Address - Fax:904-517-1619
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101681363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant