Provider Demographics
NPI:1255347233
Name:OWNBY, RAYMOND L (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:L
Last Name:OWNBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3200 S UNIVERSITY DR
Mailing Address - Street 2:ROOM 1477
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-2018
Mailing Address - Country:US
Mailing Address - Phone:954-262-1481
Mailing Address - Fax:954-262-3753
Practice Address - Street 1:3200 S UNIVERSITY DR
Practice Address - Street 2:ROOM 1477
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-2018
Practice Address - Country:US
Practice Address - Phone:954-262-1481
Practice Address - Fax:954-262-3753
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME694002084P0800X, 2084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2511622-00Medicaid
FL31457Medicare ID - Type Unspecified
FL2511622-00Medicaid