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NPI Code Detail

MEDICARE: GENNELL BOWEN

MEDICARE: GENNELL BOWEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologistAY1778FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174916324
Entity Type Code : Individual
Provider Name (Legal Business Name) : GENNELL BOWEN
Provider Business Mailing Address
First Line : 7820 PETERS RD STE E103
Second Line :
City : PLANTATION
State : FL
Zip : 33324-4019
Country : US
Telephone Number : 954-961-3456
Fax Number :
Provider Business Practice Location Address
First Line : 7820 PETERS RD STE E103
Second Line :
City : PLANTATION
State : FL
Zip : 33324-4019
Country : US
Telephone Number : 954-961-3456
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2015
Last Update Date : 04/28/2025

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Directions to “ GENNELL BOWEN ” Practice Location

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