Provider Demographics
NPI:1225126022
Name:ROWE, STEPHANIE (OD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:ROWE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8491 NW 39TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-5635
Mailing Address - Country:US
Mailing Address - Phone:352-331-1773
Mailing Address - Fax:352-792-6223
Practice Address - Street 1:8491 NW 39TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-5635
Practice Address - Country:US
Practice Address - Phone:523-331-1773
Practice Address - Fax:523-792-6223
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002302152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
V09031Medicare UPIN