Provider Demographics
NPI:1437248416
Name:COWLING, DANIEL L (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:L
Last Name:COWLING
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:495 N COURTENAY PKWY
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-3485
Mailing Address - Country:US
Mailing Address - Phone:321-454-3100
Mailing Address - Fax:321-453-1365
Practice Address - Street 1:495 N COURTENAY PKWY
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-3485
Practice Address - Country:US
Practice Address - Phone:321-454-3100
Practice Address - Fax:321-453-1365
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2267152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4413970001Medicare NSC
FL19988Medicare PIN
FLU25039Medicare UPIN