Provider Demographics
NPI:1982671624
Name:BOWDEN, REBECCA L (DO)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:L
Last Name:BOWDEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 CARLTON ST
Mailing Address - Street 2:
Mailing Address - City:WAUCHULA
Mailing Address - State:FL
Mailing Address - Zip Code:33873-3407
Mailing Address - Country:US
Mailing Address - Phone:863-773-6606
Mailing Address - Fax:863-773-9542
Practice Address - Street 1:515 CARLTON ST
Practice Address - Street 2:
Practice Address - City:WAUCHULA
Practice Address - State:FL
Practice Address - Zip Code:33873-3407
Practice Address - Country:US
Practice Address - Phone:863-773-6606
Practice Address - Fax:863-773-9542
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8449207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL229615OtherAMERIGROUP UC
FL2242875OtherUHC
FL264052000Medicaid
FL301386OtherWELLCARE UC
FLP00014147OtherRAILROAD
FL00461OtherUNIVERSAL MEDICARE MASTERPIECE
FL15654OtherBCBS
FL191851OtherAMERIGROUP
FL201265OtherWELLCARE PARRISH
FL315479OtherWELLCARE EDGAR PRICE
FL033912Medicare ID - Type UnspecifiedMEDICARE
FL2242875OtherUHC