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General NPI Number Information
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NPI Number | 1457384091
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Entity Type | Organization
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Legal Business Name | LISA BOWERS MD PA
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 10/06/2009
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Provider Practice Location Address
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Address Line | 1405 S ORANGE AVE SUITE 400
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City | ORLANDO
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State | FL
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Zip | 32806-2154
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Country | US
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Telephone | 407-667-0444
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Fax | 407-667-4338
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Provider Business Mailing Address
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Address Line | 291 SOUTHHALL LANE
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City | MAITLAND
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State | FL
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Zip | 32751
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Country | US
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Telephone | 407-667-0444
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Fax | 407-667-4338
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Authorized Official
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Title or Position | OWNER
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Name | DR. LISA A BOWERS
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Credential | MD
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Telephone | 407-667-0444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME72092
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License Number State | FL
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