Healthcare Provider Details

I. General information

NPI: 1487063418
Provider Name (Legal Business Name): CHANDRA S DOWD LMT CNMT CSM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2014
Last Update Date: 08/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 N LAKEMONT AVE
WINTER PARK FL
32792-3204
US

IV. Provider business mailing address

628 IRIS ST
ALTAMONTE SPRINGS FL
32714-3117
US

V. Phone/Fax

Practice location:
  • Phone: 407-339-2225
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberMA#049926
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: