Basic Information
| Provider Information | |||||||||
| NPI: | 1003800178 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FOWLER | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | JOSEPH | ||||||||
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| Credential: | CRNA,MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3994 SW 102ND PL | ||||||||
| Address2: | |||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522742474 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3241 SW 34TH ST | ||||||||
| Address2: | |||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344747439 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522375906 | ||||||||
| FaxNumber: | 3522378758 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | ARNP1809162 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.