Provider Demographics
NPI:1497741292
Name:LOWY, GINA (PA)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:LOWY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 NW 13TH ST STE 206
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2350
Mailing Address - Country:US
Mailing Address - Phone:561-338-3267
Mailing Address - Fax:561-391-4420
Practice Address - Street 1:1800 W WOOLBRIGHT RD STE 201
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-6398
Practice Address - Country:US
Practice Address - Phone:561-737-8584
Practice Address - Fax:561-737-5703
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9102526363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL291812900Medicaid
FL291812900Medicaid
FLQ02236Medicare UPIN