Provider Demographics
NPI:1063462216
Name:COWLES, DANA N (DO)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:N
Last Name:COWLES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1856 ALAQUA DR
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-3103
Mailing Address - Country:US
Mailing Address - Phone:407-257-5457
Mailing Address - Fax:
Practice Address - Street 1:1856 ALAQUA DR
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-3103
Practice Address - Country:US
Practice Address - Phone:407-257-5457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9752207P00000X
NY234820207P00000X
MI5101027855207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276090800Medicaid
FLP00344131OtherRAILROAD MEDICARE
FL56395OtherBCBS
FL56395OtherBCBS
FLI63679Medicare UPIN