Provider Demographics
NPI:1972704765
Name:MCDOWELL, TIMOTHY W (ANP)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:W
Last Name:MCDOWELL
Suffix:
Gender:M
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 E OAKLAND PARK BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-4434
Mailing Address - Country:US
Mailing Address - Phone:954-565-0875
Mailing Address - Fax:954-565-0876
Practice Address - Street 1:1421 E OAKLAND PARK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-4434
Practice Address - Country:US
Practice Address - Phone:954-565-0875
Practice Address - Fax:954-565-0876
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001767363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health