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General NPI Number Information
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NPI Number | 1528325198
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Entity Type | Individual
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Provider Name | IAN WINSTON FOWLER DO
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Gender | Male
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 1800 NW 10TH AVE STE T-215
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City | MIAMI
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State | FL
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Zip | 33136-1018
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Country | US
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Telephone | 602-619-0123
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 NW 10TH AVE STE T-215
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City | MIAMI
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State | FL
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Zip | 33136-1018
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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 |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 1055
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 19231
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License Number State | FL
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