MEDICARE: DAVID H OWEN MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086X0206X	Surgical Oncology Physician

General Provider Information

NPI Number	:	1073834883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID H OWEN MD PA

Provider Business Mailing Address
First Line	:	2623 S SEACREST BLVD STE 108
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-7531
Country	:	US
Telephone Number	:	561-733-6565
Fax Number	:	561-369-2110

Provider Business Practice Location Address
First Line	:	2623 S SEACREST BLVD STE 108
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-7531
Country	:	US
Telephone Number	:	561-733-6565
Fax Number	:	561-369-2110

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID H OWEN
Credential	:	MD
Telephone Number	:	561-733-6565

Provider Enumeration Date	:	06/15/2010
Last Update Date	:	06/15/2010

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