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General NPI Number Information
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NPI Number | 1487214888
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Entity Type | Individual
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Provider Name | BISMA GOWANI DPM
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Gender | Female
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Dates
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Enumeration Date | 06/18/2019
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 9950 STIRLING RD STE 108
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City | HOLLYWOOD
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State | FL
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Zip | 33024-8001
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Country | US
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Telephone | 407-463-8621
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Fax |
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Provider Business Mailing Address
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Address Line | 8721 LAKE TIBET CT
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City | ORLANDO
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State | FL
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Zip | 32836-5481
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Country | US
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Telephone | 407-463-8621
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Fax |
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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 | 213EP0504X
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Taxonomy Name | Public Medicine Podiatrist
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License Number | E5991
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | E5991
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO4359
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License Number State | FL
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