Healthcare Provider Details

I. General information

NPI: 1013803238
Provider Name (Legal Business Name): ALEXIS MARIE BOWDISH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 ANTILLES LN
SPRING HILL FL
34606-4506
US

IV. Provider business mailing address

1003 BRIAN DR
MANTENO IL
60950-3710
US

V. Phone/Fax

Practice location:
  • Phone: 352-678-5246
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number11044896
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: