Provider Demographics
NPI:1467818765
Name:MCDOWELL, ANTONIA RENEE (DPT)
Entity Type:Individual
Prefix:DR
First Name:ANTONIA
Middle Name:RENEE
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 E HIBISCUS BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3252
Mailing Address - Country:US
Mailing Address - Phone:321-802-5655
Mailing Address - Fax:
Practice Address - Street 1:801 E HIBISCUS BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3252
Practice Address - Country:US
Practice Address - Phone:321-802-5655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL31078225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist