Healthcare Provider Details

I. General information

NPI: 1497334825
Provider Name (Legal Business Name): MICHAEL RUSSELL MCDOWELL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2021
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 SW 10TH PL BLDG 1 UNITS 110-113
CAPE CORAL FL
33991-1726
US

IV. Provider business mailing address

2675 WINKLER AVE FL 2
FORT MYERS FL
33901-9342
US

V. Phone/Fax

Practice location:
  • Phone: 239-567-9482
  • Fax: 239-567-9483
Mailing address:
  • Phone: 877-856-3774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS21724
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: