Healthcare Provider Details
I. General information
NPI: 1952363996
Provider Name (Legal Business Name): DOWELL ORTHOPEDIC APPLIANCES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/05/2006
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2103 SW 27TH AVE
MIAMI FL
33145-3415
US
IV. Provider business mailing address
2103 SW 27TH AVE
MIAMI FL
33145-3415
US
V. Phone/Fax
- Phone: 305-859-9544
- Fax: 305-859-9947
- Phone: 305-859-9544
- Fax: 305-859-9947
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | ORF19 |
| License Number State | FL |
VIII. Authorized Official
Name: MR.
THOMAS
GILBERTO
DOWELL
Title or Position: OWNER
Credential: BOCPO,CFO
Phone: 305-859-9544