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NPI Code Detail

MEDICARE: MR. JOSHUA FOWLER I

MEDICARE: MR. JOSHUA FOWLER I
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
1103K00000XBehavior Analyst12690967FL

General Provider Information

NPI Number : 1407621261
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSHUA FOWLER I
Provider Business Mailing Address
First Line : 4750 COLLEGIATE DR
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-1000
Country : US
Telephone Number : 850-770-2241
Fax Number :
Provider Business Practice Location Address
First Line : 4750 COLLEGIATE DR
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-1000
Country : US
Telephone Number : 850-770-2241
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2023
Last Update Date : 06/23/2026

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