Provider Demographics
NPI:1689658155
Name:COWAN, DAVID F (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:F
Last Name:COWAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 S ORANGE AVE
Mailing Address - Street 2:ORLANDO
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-6216
Mailing Address - Country:US
Mailing Address - Phone:407-855-2526
Mailing Address - Fax:407-855-1503
Practice Address - Street 1:3615 S ORANGE AVE
Practice Address - Street 2:ORLANDO
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-6216
Practice Address - Country:US
Practice Address - Phone:407-855-2526
Practice Address - Fax:407-855-1503
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0038692207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00004527OtherRAIL ROAD MEDICARE
FL30499OtherBLUE CROSS BLUE SHIELD
FL1640380OtherCIGNA
FL4017854OtherAETNA
FLD54020Medicare UPIN
FLP00004527OtherRAIL ROAD MEDICARE