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NPI Code Detail

MEDICARE: JAE-AN BOWEN

MEDICARE: JAE-AN BOWEN
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
1106S00000XBehavior TechnicianFL

General Provider Information

NPI Number : 1295689966
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAE-AN BOWEN
Provider Business Mailing Address
First Line : 1532 SW MAPP RD
Second Line :
City : PALM CITY
State : FL
Zip : 34990-2446
Country : US
Telephone Number : 772-678-6704
Fax Number :
Provider Business Practice Location Address
First Line : 1532 SW MAPP RD
Second Line :
City : PALM CITY
State : FL
Zip : 34990-2446
Country : US
Telephone Number : 772-678-6704
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2026
Last Update Date : 02/20/2026

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Directions to “ JAE-AN BOWEN ” Practice Location

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