Provider Demographics
NPI:1720422942
Name:ELOWITZ, JASON
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:ELOWITZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19723 BRICKEL POINT DR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-4503
Mailing Address - Country:US
Mailing Address - Phone:561-716-0804
Mailing Address - Fax:
Practice Address - Street 1:19723 BRICKEL POINT DR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-4503
Practice Address - Country:US
Practice Address - Phone:561-716-0804
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist