Healthcare Provider Details

I. General information

NPI: 1114907409
Provider Name (Legal Business Name): LOWELL SCOTT DAVIS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 09/15/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 NW 150 AVE SUITE 100
PEMBROKE PINES FL
33028
US

IV. Provider business mailing address

2010 NW 150 AVE SUITE 100
PEMBROKE PINES FL
33028
US

V. Phone/Fax

Practice location:
  • Phone: 954-447-5206
  • Fax: 954-447-5259
Mailing address:
  • Phone: 954-447-5206
  • Fax: 954-447-5259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberOS9166
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberOS9166
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: