Individual
AUDREY T. BOWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13535 NEMOURS PKWY, ORLANDO, FL 32827-7402
(407) 567-4000
(407) 567-5924
Mailing address
10140 CENTURION PKWY N, PROVIDER ENROLLMENT DEPARTMENT, JACKSONVILLE, FL 32256-0532
(904) 697-4127
(904) 697-5102
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
ME0065832
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250650500
—
FL
Enumeration date
10/05/2005
Last updated
07/21/2022
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