Individual
FRED I HOWARD III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
451 S 11TH ST, LAKE WALES, FL 33853
(863) 679-1986
(863) 676-3126
Mailing address
451 S 11TH ST, LAKE WALES, FL 33853-4251
(863) 679-1986
(863) 676-3126
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME82331
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020051510
MEDICARE ID/RRM PIN
FL
05
—
261553300
—
FL
Enumeration date
03/14/2006
Last updated
09/26/2019
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