Healthcare Provider Details

I. General information

NPI: 1457596355
Provider Name (Legal Business Name): TOMAS GILBERTO DOWELL CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: TOMAS G DOWELL LICENSE CPO

II. Dates (important events)

Enumeration Date: 12/05/2008
Last Update Date: 12/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NW 16TH ST
MIAMI FL
33125-1624
US

IV. Provider business mailing address

1201 NW 16TH ST
MIAMI FL
33125-1624
US

V. Phone/Fax

Practice location:
  • Phone: 305-575-3109
  • Fax: 305-575-3245
Mailing address:
  • Phone: 305-575-3109
  • Fax: 305-575-3245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberPRO10
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: