Provider Demographics
NPI:1407191208
Name:HOWARD, FELICIA CAROL (DO)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:CAROL
Last Name:HOWARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:CAROL
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:905 SANDPIPER LN
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-5202
Mailing Address - Country:US
Mailing Address - Phone:786-283-0582
Mailing Address - Fax:
Practice Address - Street 1:1190 37TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6507
Practice Address - Country:US
Practice Address - Phone:772-563-4666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOU29552084P0800X
PAOS0169392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1407191208Medicaid