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General NPI Number Information
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NPI Number | 1053423699
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Entity Type | Individual
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Provider Name | JAMES RICHARD BOWEN JR. B.C.O., B.A.D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 06/28/2021
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Provider Practice Location Address
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Address Line | 10 SOUTH BUMBY AVE
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City | ORLANDO
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State | FL
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Zip | 32803-3280
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Country | US
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Telephone | 407-493-2603
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Fax | 407-246-0222
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Provider Business Mailing Address
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Address Line | PO BOX 361216
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City | MELBOURNE
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State | FL
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Zip | 32936-1216
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Country | US
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Telephone | 407-246-5451
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Fax | 407-246-0222
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1700X
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Taxonomy Name | Ocularist
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License Number |
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License Number State |
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