Provider Demographics
NPI:1396001046
Name:COWIN, RICHARD MARTIN (DPM)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MARTIN
Last Name:COWIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7932 W. SAND LAKE RD.
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819
Mailing Address - Country:US
Mailing Address - Phone:407-722-8750
Mailing Address - Fax:407-722-8748
Practice Address - Street 1:7932 W. SAND LAKE RD.
Practice Address - Street 2:SUITE 106
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819
Practice Address - Country:US
Practice Address - Phone:407-722-8750
Practice Address - Fax:407-722-8748
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-06
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 1295213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery