Individual
GERALD A COWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
301 SW PINE ISLAND RD, CAPE CORAL, FL 33991-2043
(239) 800-6032
(239) 574-9038
Mailing address
1403 SW 8TH CT, CAPE CORAL, FL 33991-2902
(239) 677-8998
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2010037748
MO
152W00000X
Optometrist
OPC4121
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104992585
—
MO
01
—
P00369126
RAIL ROAD MEDICARE
FL
Enumeration date
11/28/2006
Last updated
11/14/2019
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