Provider Demographics
NPI:1851609911
Name:LOEWE, JENNIFER MICHELLE (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MICHELLE
Last Name:LOEWE
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11200 SW 8TH ST
Mailing Address - Street 2:USCB ARENA, 156
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33199-2516
Mailing Address - Country:US
Mailing Address - Phone:305-348-0131
Mailing Address - Fax:305-348-3673
Practice Address - Street 1:11200 SW 8TH ST
Practice Address - Street 2:USCB ARENA, 156
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33199-2516
Practice Address - Country:US
Practice Address - Phone:305-348-0131
Practice Address - Fax:305-348-3673
Is Sole Proprietor?:No
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 2777174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist