Provider Demographics
NPI:1457897423
Name:OGAYRE, LOWELA
Entity type:Individual
Prefix:MS
First Name:LOWELA
Middle Name:
Last Name:OGAYRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 NW 125TH AVE APT 10301
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-5241
Mailing Address - Country:US
Mailing Address - Phone:954-939-1947
Mailing Address - Fax:
Practice Address - Street 1:1520 NW 125TH AVE APT 10301
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-5241
Practice Address - Country:US
Practice Address - Phone:954-939-1947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010868225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLW2320 50097OtherAETNA