Healthcare Provider Details

I. General information

NPI: 1831930429
Provider Name (Legal Business Name): ERIC KEITH ROWINSKY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S OCEAN BLVD APT 306
BOCA RATON FL
33432-8523
US

IV. Provider business mailing address

1500 S OCEAN BLVD APT 306
BOCA RATON FL
33432-8523
US

V. Phone/Fax

Practice location:
  • Phone: 908-883-0647
  • Fax:
Mailing address:
  • Phone: 908-883-0647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberK1644
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: