Individual
CAROL PATRICIA ROBERTINE BOWEN-WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3 SHIRCLIFF WAY, SUITE 630, JACKSONVILLE, FL 32204-4776
(904) 281-5878
(904) 645-5856
Mailing address
3 SHIRCLIFF WAY, SUITE 630, JACKSONVILLE, FL 32204-4776
(904) 281-5878
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
41473
KY
2086X0206X
Surgical Oncology Physician
41473
KY
2086X0206X
Surgical Oncology Physician
Primary
ME104932
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013091-00
—
FL
01
—
37903705
MEDICAID LAB GROUP
KY
01
—
4000501
MEDICARE LAB GROUP
KY
Enumeration date
09/26/2007
Last updated
03/14/2011
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