Healthcare Provider Details

I. General information

NPI: 1487509410
Provider Name (Legal Business Name): CAMERON OWEN PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3347 FL-7 SUITE 101
WELLINGTON FL
33449
US

IV. Provider business mailing address

9801 BELVEDERE RD
ROYAL PALM BEACH FL
33411-3640
US

V. Phone/Fax

Practice location:
  • Phone: 561-790-2111
  • Fax:
Mailing address:
  • Phone: 561-273-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9121839
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: