1295845881 NPI number — DR. JUDY GARARD ROWLAND DDS

Table of content: DR. JUDY GARARD ROWLAND DDS (NPI 1295845881)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295845881 NPI number — DR. JUDY GARARD ROWLAND DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROWLAND
Provider First Name:
JUDY
Provider Middle Name:
GARARD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295845881
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/17/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8369
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MADEIRA BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33738-8369
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-381-7888
Provider Business Mailing Address Fax Number:
727-347-5569

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
901 TYRONE BLVD N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33710-6332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-381-7888
Provider Business Practice Location Address Fax Number:
727-347-5569
Provider Enumeration Date:
08/30/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  DN0011814 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)