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General NPI Number Information
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NPI Number | 1194766956
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Entity Type | Individual
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Provider Name | FRED TOW M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 08/08/2017
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Provider Practice Location Address
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Address Line | 8921 RAVEN ROCK CT
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City | BOYNTON BEACH
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State | FL
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Zip | 33473-4831
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Country | US
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Telephone | 941-356-2266
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Fax |
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Provider Business Mailing Address
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Address Line | 5700 LAKE WORTH RD STE 204
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City | GREENACRES
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State | FL
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Zip | 33463-3213
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Country | US
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Telephone | 904-515-6909
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Fax | 904-515-6909
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME58474
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License Number State | FL
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