Provider Demographics
NPI:1295921054
Name:LOWEN, NATHANIEL A (MD)
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:A
Last Name:LOWEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 CLINT MOORE RD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2658
Mailing Address - Country:US
Mailing Address - Phone:561-988-8988
Mailing Address - Fax:561-912-1804
Practice Address - Street 1:1905 CLINT MOORE RD
Practice Address - Street 2:SUITE 309
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2658
Practice Address - Country:US
Practice Address - Phone:561-988-8988
Practice Address - Fax:561-912-1804
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0080640207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG69173Medicare UPIN