1538493218 NPI number — BOWEN SPEECH-LANGUAGE THERAPY, LLC

Table of content: DR. RAMON CASTRO RANESES MD (NPI 1205812856)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538493218 NPI number — BOWEN SPEECH-LANGUAGE THERAPY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BOWEN SPEECH-LANGUAGE THERAPY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1538493218
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/28/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2439 BOND AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLEARWATER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33759-1204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-515-1163
Provider Business Mailing Address Fax Number:
727-797-6250

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2439 BOND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEARWATER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33759-1204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-515-1163
Provider Business Practice Location Address Fax Number:
727-797-6250
Provider Enumeration Date:
09/28/2009

Additional Information

Authorized Official

Authorized Official Last Name:
BOWEN
Authorized Official First Name:
CYNTHIA
Authorized Official Middle Name:
WILLIAMS
Authorized Official Title or Position:
OWNER/MANAGER
Authorized Official Telephone Number:
727-515-1163

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SA9700 , 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)





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