Healthcare Provider Details

I. General information

NPI: 1508078650
Provider Name (Legal Business Name): THOMAS J. COWELL.D.C., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 E COMMERCIAL BLVD
FORT LAUDERDALE FL
33308-4208
US

IV. Provider business mailing address

2940 E COMMERCIAL BLVD
FORT LAUDERDALE FL
33308-4208
US

V. Phone/Fax

Practice location:
  • Phone: 954-776-6888
  • Fax: 954-491-2296
Mailing address:
  • Phone: 954-776-6888
  • Fax: 954-491-2296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number4382
License Number StateFL

VIII. Authorized Official

Name: DR. THOMAS JOSEPH COWELL
Title or Position: PRESIDENT
Credential: D.C.,C.C.S.P.
Phone: 954-776-6888