Healthcare Provider Details

I. General information

NPI: 1073834883
Provider Name (Legal Business Name): DAVID H OWEN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2010
Last Update Date: 06/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2623 S SEACREST BLVD STE 108
BOYNTON BEACH FL
33435-7531
US

IV. Provider business mailing address

2623 S SEACREST BLVD STE 108
BOYNTON BEACH FL
33435-7531
US

V. Phone/Fax

Practice location:
  • Phone: 561-733-6565
  • Fax: 561-369-2110
Mailing address:
  • Phone: 561-733-6565
  • Fax: 561-369-2110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID H OWEN
Title or Position: PRESIDENT
Credential: MD
Phone: 561-733-6565