Healthcare Provider Details

I. General information

NPI: 1316563927
Provider Name (Legal Business Name): JUSTIN M DOWD APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2020
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SE OCEAN BLVD
STUART FL
34994-2214
US

IV. Provider business mailing address

1 SE OCEAN BLVD
STUART FL
34994-2214
US

V. Phone/Fax

Practice location:
  • Phone: 772-877-9676
  • Fax:
Mailing address:
  • Phone: 386-872-2484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11006682
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11006682
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: