Provider Demographics
NPI:1902820046
Name:LOWE, EILEEN (MSW)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:LOWE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4506 BRANDEIS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-1470
Mailing Address - Country:US
Mailing Address - Phone:407-850-9013
Mailing Address - Fax:407-850-9013
Practice Address - Street 1:22 LAKE BEAUTY DR
Practice Address - Street 2:STE 100
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2037
Practice Address - Country:US
Practice Address - Phone:407-850-9013
Practice Address - Fax:407-850-9013
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW899104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ3668Medicare ID - Type UnspecifiedMEDICARE ID