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General NPI Number Information
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NPI Number | 1558554501
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Entity Type | Individual
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Provider Name | EUNICE SARAH MOWERY PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/23/2007
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 8045 SPYGLASS HILL RD STE 104
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City | MELBOURNE
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State | FL
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Zip | 32940-8567
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Country | US
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Telephone | 321-294-5800
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Fax | 321-241-4578
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Provider Business Mailing Address
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Address Line | 900 VILLAGE SQUARE XING STE 290
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4552
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Country | US
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Telephone | 561-693-0540
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Fax | 561-296-6174
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9104204
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License Number State | FL
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