Provider Demographics
NPI:1952363996
Name:DOWELL ORTHOPEDIC APPLIANCES, INC.
Entity Type:Organization
Organization Name:DOWELL ORTHOPEDIC APPLIANCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:GILBERTO
Authorized Official - Last Name:DOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:BOCPO,CFO
Authorized Official - Phone:305-859-9544
Mailing Address - Street 1:2103 SW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-3415
Mailing Address - Country:US
Mailing Address - Phone:305-859-9544
Mailing Address - Fax:305-859-9947
Practice Address - Street 1:2103 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-3415
Practice Address - Country:US
Practice Address - Phone:305-859-9544
Practice Address - Fax:305-859-9947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLORF19335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL026177700Medicaid
FL026177700Medicaid