Healthcare Provider Details

I. General information

NPI: 1316938319
Provider Name (Legal Business Name): TAMMY T. MCDOWELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 06/01/2020
Certification Date: 06/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7243 DELLA DR FL 3
ORLANDO FL
32819-5104
US

IV. Provider business mailing address

7243 DELLA DR FL 3
ORLANDO FL
32819-5104
US

V. Phone/Fax

Practice location:
  • Phone: 407-381-7326
  • Fax: 321-203-4664
Mailing address:
  • Phone: 407-381-7326
  • Fax: 321-203-4664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME58706
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: