Provider Demographics
NPI:1205109717
Name:BOWEN, CAREY A (HAS)
Entity type:Individual
Prefix:MR
First Name:CAREY
Middle Name:A
Last Name:BOWEN
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 S APOPKA AVE
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-4802
Mailing Address - Country:US
Mailing Address - Phone:352-726-4327
Mailing Address - Fax:352-726-3490
Practice Address - Street 1:211 S APOPKA AVE
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4802
Practice Address - Country:US
Practice Address - Phone:352-726-4327
Practice Address - Fax:352-726-3490
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4765237700000X
237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1205109717Medicaid