Provider Demographics
NPI:1154527729
Name:NOWELL, JOHN (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:NOWELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:8066 MONIER WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-2640
Mailing Address - Country:US
Mailing Address - Phone:407-822-7502
Mailing Address - Fax:407-386-6649
Practice Address - Street 1:7208 W SAND LAKE RD STE 202
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-5278
Practice Address - Country:US
Practice Address - Phone:407-271-8931
Practice Address - Fax:407-674-8712
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2202152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist