Provider Demographics
NPI:1154453363
Name:LORI LYNN DOWIE DO PA
Entity Type:Organization
Organization Name:LORI LYNN DOWIE DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DOWIE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-743-4911
Mailing Address - Street 1:11211 PROSPERITY FARMS RD
Mailing Address - Street 2:SUITE C211
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3446
Mailing Address - Country:US
Mailing Address - Phone:561-743-4911
Mailing Address - Fax:561-743-2998
Practice Address - Street 1:11211 PROSPERITY FARMS RD
Practice Address - Street 2:SUITE C211
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3446
Practice Address - Country:US
Practice Address - Phone:561-743-4911
Practice Address - Fax:561-743-2998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8016207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262188600Medicaid
FL262188600Medicaid
FL01885Medicare ID - Type Unspecified