Provider Demographics
NPI:1538122064
Name:LOWELL, BROOKE ANN (MD)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:ANN
Last Name:LOWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 UNIVERSITY DRIVE
Mailing Address - Street 2:ST K
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065
Mailing Address - Country:US
Mailing Address - Phone:954-752-2630
Mailing Address - Fax:954-752-9391
Practice Address - Street 1:3000 UNIVERSITY DRIVE
Practice Address - Street 2:SUITE K
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:954-752-2630
Practice Address - Fax:954-752-9391
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76325207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL07328254OtherAETNA
FL1995537OtherUNITED
FL2299330OtherGHI
FL35339OtherBCBS
270280OtherAVMED
FL353392XMedicare ID - Type Unspecified
FL2299330OtherGHI