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General NPI Number Information
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NPI Number | 1154527729
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Entity Type | Individual
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Provider Name | JOHN NOWELL O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 04/02/2019
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Provider Practice Location Address
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Address Line | 7208 W SAND LAKE RD STE 202
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City | ORLANDO
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State | FL
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Zip | 32819-5278
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Country | US
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Telephone | 407-271-8931
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Fax | 407-674-8712
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Provider Business Mailing Address
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Address Line | 8066 MONIER WAY
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City | ORLANDO
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State | FL
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Zip | 32835-2640
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Country | US
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Telephone | 407-822-7502
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Fax | 407-386-6649
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2202
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License Number State | FL
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