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General NPI Number Information
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NPI Number | 1235289778
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Entity Type | Organization
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Legal Business Name | EUGENE H USOW DO PA
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 09/09/2008
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Provider Practice Location Address
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Address Line | 709 SEBASTIAN BLVD SUITE F
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City | SEBASTIAN
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State | FL
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Zip | 32958-8704
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Country | US
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Telephone | 772-228-9511
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Fax |
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Provider Business Mailing Address
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Address Line | 709 SEBASTIAN BLVD SUITE F
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City | SEBASTIAN
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State | FL
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Zip | 32958-8704
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EUGENE USOW
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Credential | D.O.
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Telephone | 772-228-9511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS9612
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License Number State | FL
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