Provider Demographics
NPI:1053423699
Name:BOWEN, JAMES RICHARD JR (BCO, BADO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:RICHARD
Last Name:BOWEN
Suffix:JR
Gender:M
Credentials:BCO, BADO
Other - Prefix:
Other - First Name:RICK
Other - Middle Name:
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BCO, BADO
Mailing Address - Street 1:PO BOX 361216
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32936-1216
Mailing Address - Country:US
Mailing Address - Phone:407-246-5451
Mailing Address - Fax:407-246-0222
Practice Address - Street 1:10 SOUTH BUMBY AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-3280
Practice Address - Country:US
Practice Address - Phone:407-493-2603
Practice Address - Fax:407-246-0222
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1700XEye and Vision Services ProvidersTechnician/TechnologistOcularist